or =400 mcg/dL are associated with symptomatic iron overdose. The proportions of patients treated with deferoxamine and total dosages of deferoxamine were similar by peak iron level (> or =400 vs. ![]() 6/56, respectively), or experience maternal death (3/3 vs. 1/56, respectively), deliver preterm (2/3 vs. However, patients with stage 3 toxicity were more likely to spontaneously abort (1/3 vs. Peak iron level > or =400 mcg/dL was not associated with increased risk of spontaneous abortion, preterm delivery, congenital anomalies, or maternal death. ![]() Compared with women who had lower peak levels, women with peak serum iron levels > or =400 mcg/dL were more frequently symptomatic (12/13 vs. Fourteen publications were identified, describing 61 cases of obstetric iron overdose, including one recent case at our institution. ![]() Statistical analysis used the Student t-test, Fisher exact test, or ANOVA, as appropriate. Two investigators independently extracted data from articles and their references including stage of toxicity (0 = asymptomatic, 1 = gastrointestinal symptoms, 2 = metabolic disturbance, 3 = organ failure), with differences resolved by consensus. A computer search of the English language literature from 1966-1998 used the key words iron toxicity, iron poisoning, deferoxamine, and pregnancy to identify peer-reviewed papers reporting intentional iron overdoses in pregnancy. ![]() The objectives of our study were to 1) determine if peak maternal serum iron level or toxicity stage after intentional overdose is associated with adverse maternal-fetal outcome, and 2) describe the use of deferoxamine antidote therapy in obstetric patients.
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