EXPOSURE TO CORROSIVE AGENTS IN PREGNANCY

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(Date of issue: August 2016, Version: 1.1)

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

Corrosives encompass a diverse group of compounds that cause injury to living tissue via chemical reactions at the site of contact.  Among them, acids (low pH) and alkalis (high pH) generally have local, non-specific corrosive effects and are not associated with systemic toxicity unless high levels of exposure occur, or exposure has occurred through inhalation or ingestion.  The most common injuries after exposure to acids and alkalis are chemical burns at the site of contact, although damage to the respiratory tract or gastrointestinal tract may occur following inhalation or ingestion respectively.   

Certain corrosive compounds may however, cause specific effects associated with substantial systemic toxicity and in cases of exposure to these, the corresponding TOXBASE and UKTIS monographs for that agent should be consulted.  This monograph discusses the non-specific corrosive effects of exposure to acids and alkalis during pregnancy. 

There are limited data regarding exposure to acids and alkalis during pregnancy, therefore it is not possible to provide an evidence-based risk assessment.  Acids and alkalis mediate their effects locally and absorption and systemic toxicity are not generally encountered.  Therefore, exposure to acids and alkalis during pregnancy is unlikely to have a direct effect on the developing fetus.  However, symptoms associated with maternal injury may have adverse fetal effects. 

As with all chemicals, unnecessary exposure to acids and alkalis should be avoided during pregnancy.  Asymptomatic exposure to acids and alkalis at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy.  However, other risk factors may 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. Discussion with UKTIS is recommended in such cases. 

In cases of symptomatic maternal exposure to acids and alkalis in pregnancy, enhanced fetal monitoring may be required.  The severity of the systemic symptoms observed as a result of exposure is likely to be a major determinant of fetal effects.  It is therefore important to treat the mother appropriately to reduce the risks of maternal, and as a consequence, fetal toxicity.  If a specific treatment is required, it should not be withheld on account of pregnancy. Where alternatives exist, UKTIS should be contacted for advice regarding the use of antibiotics, pain killers and diagnostic techniques for use in pregnant patients.

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.