Venomous Snake and Spider Bites in Pregnancy.

IMPORTANCE: Venomous snake and spider bites are relatively rare in the Unites States and even more so in the pregnant population. However, the impact of a venomous bite, also known as an envenomation, can be serious in a pregnant patient. Thus, providers in endemic and high-risk areas must be familiar with the management of envenomation in the pregnant population. OBJECTIVE: The purpose of this article is to review the current literature on the most common snake and spider envenomations in the United States, the effects of envenomation on maternal and fetal health, and the management of envenomation in pregnancy. EVIDENCE ACQUISITION: Original research articles, review articles, and guidelines on snake and spider envenomation were reviewed. RESULTS: Snake envenomation carries higher risks of maternal morbidity and fetal morbidity and mortality than spider envenomation. Although the data are limited, current literature suggests that both snake and spider antivenom can be used in the pregnant population without significant adverse outcomes. However, the risks of an adverse hypersensitivity reaction with antivenom administration should be weighed carefully with the benefits. CONCLUSIONS AND RELEVANCE: The use of antivenom therapy in the symptomatic envenomated pregnant population is likely safe with the appropriate monitoring and follow-up. Knowledge of the indications for antivenom therapy and proper escalation of care are vital to optimizing maternal and fetal outcomes. More research is needed to determine the effects of both envenomation and antivenom therapy on the pregnant patient and their fetus.

Duke Scholars

Author Sarah K. Dotters-Katz Obstetrics and Gynecology, Maternal Fetal Medicine

Author Jeffrey Adam Kuller Obstetrics and Gynecology, Maternal Fetal Medicine