USE OF ETHYLENE GLYCOL IN PREGNANCY

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(Date of issue: May 2016, Version: 2)

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

Ethylene glycol is an odourless, colourless, sweet-tasting liquid used as a coolant in brake fluid and antifreeze, and a precursor in polymer manufacture.

As with all chemicals, unnecessary exposure to ethylene glycol should be avoided during pregnancy. However, where occupational exposure is unavoidable, precautions should be taken to ensure that exposure is well within the recommended exposure limits and not associated with toxic symptoms. Data following acute exposure are limited, and there are no published data available on occupational exposure to ethylene glycol during pregnancy.

Maternal toxicity is likely to be a major determinant of risk to the fetus following ethylene glycol exposure. However, due to a lack of data concerning the teratogenicity of ethylene glycol, it is not currently possible to state that an absence of maternal toxicity excludes the possibility of adverse events occurring in the developing fetus.

The severity of complications associated with ethylene glycol poisoning mandates the same treatment for pregnant and non-pregnant patients. There is very limited data available concerning the use of the antidotes fomepizole and ethanol in pregnancy. However, when antidote use is indicated, the maternal and fetal benefits are likely to outweigh the risks associated with untreated ethylene glycol poisoning. If treatment with an antidote is required then fomepizole is preferred at all stages of pregnancy as ethanol can cause harmful fetal effects. In cases where fomepizole is either unavailable or not considered appropriate, ethanol should not be withheld on the account of pregnancy.

Exposure to ethylene glycol alone 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. In all cases of ethylene glycol 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.