EXPOSURE TO AMMONIA IN PREGNANCY

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(Date of issue: May 2017, Version: 2.1)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

Summary

Ammonia is a colourless gas with a strong characteristic odour similar to urine that allows its detection at low levels.  Ammonia compounds are used in fertilisers, plastics, synthetic fibres, dyes, explosives, pharmaceuticals, and are a major component of many common household cleaning products.

There are no published studies on the effects of exposure to ammonia in human pregnancy. As with all chemicals, unnecessary exposure to ammonia during pregnancy should be avoided due to a lack of information on safety. Where exposure is expected to occur, it should be well within the recommended exposure limits and not associated with toxic symptoms. There is currently no indication that normal use of household products containing ammonia poses a hazard.

Following acute ammonia exposure in a pregnant patient, maternal toxicity is likely to be a major determinant of fetal risk. However, due to a lack of data relating to the teratogenicity of ammonia, it is not currently possible to state that an absence of maternal toxicity excludes the possibility of adverse effects on the developing fetus. Treatment should be as for the non-pregnant patient. 

Exposure to ammonia at any stage of pregnancy would not usually be regarded as medical grounds for termination of pregnancy. Where maternal toxicity is evident, additional fetal monitoring may be warranted, particularly if exposure is associated with maternal hypoxia. Discussion with UKTIS is recommended in such cases. Other risk factors may also be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.
                      
This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.