Bothropic snakebite in preterm pregnancy: Antivenom and clinical outcome in mother and newborn in Cúcuta, Colombia

Abstract

Snakebite envenomation remains a neglected public health problem in many tropical and subtropical countries. It mainly affects rural populations and has a higher incidence in men. Most cases have been reported in Africa, Latin America, and Asia. More than 300 species of snakes have been identified in Colombia, of which around 18% are of medical importance. This fact places the country as the third with the highest number of cases in the region, with 6,231 reported by 2023.
Snakebite envenomation in pregnant women is a rare event, and it implies a higher risk of fetal and neonatal death. We report the case of a newborn with neonatal hypoxia and fetal distress, resulting from a cesarean section of a 22-year-old primigravida at 36 weeks of gestation after an ophidian accident involving a bite in the dorsum of her left hand. The newborn was admitted to the intensive care unit in critical condition and with progressive clinical deterioration. However, following the timely administration of antivenom and mechanical ventilation, the infant showed a remarkable recovery and was discharged after only 12 days of hospitalization.
We underline the need to improve the availability of antivenoms and to strengthen pharmacovigilance systems to ensure their effectiveness and safety. In conclusion, this clinical case highlights the importance of an early consultation, the availability and prompt administration of the antivenom, and the expertise of healthcare workers in managing this event in pregnant women and neonates.