Summary
Brevetoxins are cyclic polyether neurotoxic compounds produced in marine organisms such as the dinoflagellate Karenia brevis that bioaccumulate in filter feeding molluscs. Brevetoxins bind to the sodium channels in nerve cells leading to disruption of neurological processes resulting in neurotoxic shellfish poisoning. Aerosolisaton of brevetoxin is also possible during algal blooms, when the action of waves and the wind may break open the dinoflagellate releasing the toxin.
Owing to the potential severity of brevetoxin exposure, treatment during pregnancy should be the same as for the non-pregnant patient. Maternal toxicity is likely to be a major determinant of risk to the fetus after maternal brevetoxin exposure.
Due to a lack of data following exposure in human pregnancy, it is not currently possible to offer an evidence-based assessment of the risk that maternal brevetoxin exposure poses to a developing fetus. Where exposure to brevetoxin has occurred, even in cases which did not result in maternal toxicity, enhanced fetal monitoring may be warranted. Discussion with UKTIS is recommended in all cases.
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