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EXPOSURE TO PHOSGENE IN PREGNANCY

Date of issue: September 2017
Version: 1.3

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

Under normal atmospheric conditions, phosgene is a colourless gas with an odour described as similar to cut grass or hay.  At lower temperatures and/or pressure, phosgene becomes liquefied with a slightly yellow appearance.  Phosgene is used in the production of precursor materials for plastics manufacture, in the manufacture of isocyanates, dyes, pesticides and pharmaceuticals, and has been used as a chemical weapon.

Phosgene is highly toxic.  Exposure occurs primarily through inhalation or ocular contact with phosgene gas.  Dermal contact to phosgene liquid may also occur.  Ingestion of phosgene is unlikely.  Symptoms of toxicity may be delayed following exposure.

There are no guidelines regarding the treatment of phosgene poisoning during pregnancy.  Owing to the severity of complications associated with phosgene poisoning, treatment of the pregnant patient should be the same as for the non-pregnant patient.

Due to a lack of data, it is not possible to assess the risk exposure poses to a developing fetus.  Following phosgene exposure in a pregnant patient, maternal toxicity is likely to be a major determinant of fetal risk.  However, due to a lack of data concerning the teratogenicity of phosgene, it is not currently possible to state that an absence of maternal toxicity excludes the possibility of adverse events occurring in the developing fetus.  In all cases of phosgene exposure in pregnancy, extended maternal and fetal monitoring may be warranted.  Discussion with UKTIS is recommended in all cases.

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.