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Acetaminophen (APAP) is the most common drug overdose in pregnancy. Available data regarding APAP overdose in pregnancy is limited to case reports and a small prospective case series. APAP has been demonstrated to cross the placenta and in toxic doses may harm the fetal and maternal hepatocytes.
Maternal treatment of paracetamol overdose should be as for the non-pregnant patient. There is evidence linking a delay in treating a pregnant patient with N-acetylcysteine (NAC) with increased fetotoxic effects. Treatment with NAC should not be withheld on the basis of pregnancy.
CONCLUSIONS: Pregnant women with acute APAP overdose should be treated early with IV NAC. Delayed therapy is associated with maternal and fetal hepatotoxicity. Overdose, in the presence or abscence of hepatotoxicity, may precipitate premature labor and fetal death.
Acetaminophen (APAP) is the most common drug overdose in pregnancy. Available data regarding APAP overdose in pregnancy is limited to case reports and a small prospective case series. APAP has been demonstrated to cross the placenta and in toxic doses may harm the fetal and maternal hepatocytes.
Most patients with APAP overdose have minimal or nonspecific symptoms such as malaise, abdominal pain or nausea, and vomiting at presentation. A detailed medication history can help ascertain total APAP exposure but can be challenging in patients with polydrug overdose or advanced encephalopathy.
23 lip 2021 · All the current available guidelines for management of COVID-19 pregnant patients with different disease severity starting from asymptomatic and passing through those with mild, moderate, and severe disease and reaching the management of critically ill patients were explained.
To achieve optimal outcome following acetaminophen overdose, a systematic management approach is needed. This section outlines basic steps in managing acute acetaminophen overdose, consistent with FDA approved labeling of acetylcysteine. Flowchart 1 outlines this stepwise approach. 1. Initial Assessment