A case report of pregnant mother death due to severe DIC caused by a scorpion sting

Document Type : Case report

Authors

1 Instructor, Department of Midwifery, Faculty of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.

2 M.Sc. of Midwifery, Faculty of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.

3 Health Economics Expert, Faculty of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.

Abstract

Introduction: Scorpion bite is an important health issue that in many cases occurs in Sistan and Baluchistan province. Severe complications of scorpion bite include: decreased renal blood flow, renal failure, severe hemolysis, pancreatitis, hepatitis, DIC, miscarriage, and death. In this study, a case of mother's death due to DIC caused by scorpion bite is reported.
Case presentation: A 19-year-old primigravid woman with the gestational age of 33 weeks, 5 days after being bitten by a scorpion, following a decrease in the level of consciousness with GCS: 3/15, intubation,undergoing blood transfusion was transferred from Rusk Hospital and admitted to the ICU ward. After being sent to Iranshahr, the patient was examined by anesthesiologist and gynecologist. In the examinations, severe lung rales were heard and bruises caused by scorpion bite were observed on the left side. In ultrasound, a fetus without heartbeat, biliary edema and hydronephrosis were evident. Induction and antiserum treatment started for scorpion stings. Four hours later, mother suddenly had bradycardia and asystole, CPR was performed and despite 45 minutes of CPR, the patient died.
Conclusion: In this patient, due to delay in transferring her to the medical center caused the doctors to fail to save her in time. If the patient bitten by scorpion does not come to hospital within the first 6 hours, she will lose the chance of treatment, and if the more time passes, she will face the risk of death due to the infiltration of poison into the bloodstream, so a person bitten by scorpion should refer to the hospital at the first opportunity and special tests should be performed.

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  1. Baride RM, Jain SD, Gaitonde BB. Immunological and biochemical studies on the formolised toxoid of red scorpion venom. Indian J Med Res 1981; 73:122-5.
  2. Vazirianzadeh B, Nourmandi Pour S, Hashemi Shahraki A, Dehghani R, Amraee K. A study on some epidemiologic parameters among scorpion stung people who referred to Sirjan health centre, Kerman province of Iran in 2007-2009. Jentashapir J Cell Mol Biol 2012; 3(4):539-41.
  3. Basu K, Mondal RK, Banerjee DP. Epidemiological aspects of acute childhood poisoning among patients attending a hospital at Kolkata. Indian journal of public health 2005; 49(1):25.
  4. Mirakabadi A, et al. Prevention, care, treatment and bites of poisonous animals (scorpions). Tehran: Tandis; 2018.
  5. Daneshi S, Rezabeigi S, Razzaghi A, Zeinali M, Arefi S. Comparing the effectiveness of emotion regulation group training based on process model of gross on use of reappraisal and suppression strategies among adolescent girls with symptom of BPD and ADHD. pajoohande 2016; 21(1):35-39.
  6. Hosseininasab A, Alidoosti K, Torabinejad M. Epidemiologic characteristic and predisposing factors of scorpion sting in the south of Kerman province. Journal of Medical Council of Islamic Republic of IRAN 2009; 27(3):295-301.
  7. Scorpion sting; 2022. available at: https://arakmu.ac.ir/valfajrhos/fa/page/2535/%D8%B9%D9%82%D8%B1%D8%A8-%DA%AF%D8%B2%DB%8C%D8%AF%DA%AF%DB%8C.%202022
  8. Najafian M, Ghorbani A, Zargar M, Baradaran M, Baradaran N. Scorpion stings in pregnancy: an analysis of outcomes in 66 envenomed pregnant patients in Iran. Journal of Venomous Animals and Toxins including Tropical Diseases 2020; 26.
  9. Mirakabadi A. Scorpion sting, first aid and treatment and prevention. Tabibzadeh Publishing Cultural Institute; 2006.
  10. Langley RL. A review of venomous animal bites and stings in pregnant patients. Wilderness & environmental medicine 2004; 15(3):207-15.
  11. Leibenson L, Leibenson M, Silberstein T. Antepartum fetal death following a yellow scorpion sting. Archives of gynecology and obstetrics 2010; 281:247-9.
  12. Zengin S, Al B, Oktay MM, Kilic H. Scorpion sting: eclampsia. Case Reports 2012; 2012:bcr1220115401.
  13. Marei ZA, Ibrahim SA. Stimulation of rat uterus by venom from the scorpion L. quinquestriatus. Toxicon 1979; 17(3):251-8.
  14. Bosnak M, Ece A, Yolbas I, Bosnak V, Kaplan M, Gurkan F. Scorpion sting envenomation in children in southeast Turkey. Wilderness & environmental medicine 2009; 20(2):118-24.
  15. Nazari M, Bahrami D, Davari B, Salehzadeh A. Epidemiological survey of scorpion sting cases and identification of scorpion fauna in Hamadan city, Iran (2013). Avicenna Journal of Clinical Medicine 2015; 22(3):255-62.
  16. The bitter death of a pregnant woman due to a scorpion bite ; 2017. available at: https://www.khabaronline.ir/news/679131/%D9%85%D8%B1%DA%AF-%D8%AA%D9%84%D8%AE-%D8%B2%D9%86-%D8%A8%D8%A7%D8%B1%D8%AF%D8%A7%D8%B1-%D8%A8%D8%B1-%D8%A7%D8%AB%D8%B1-%D9%86%DB%8C%D8%B4-%D8%B9%D9%82%D8%B1%D8%A8 2015.