Research Day

Maternal Death By Fire And Fetal Carboxyhemoglobin Level

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INTRODUCTION: The effect of maternal carbon monoxide exposure on fetuses is an under-reported topic. The relationship between maternal carboxyhemoglobin levels and fetal carboxyhemoglobin levels has yet to be fully explained.

CASE REPORT: An 8-month pregnant 35-year-old woman died in a house fire caused by an overloaded extension cord. Postmortem examination documented extensive fire-related changes, which included singed hair, diffuse charring of the skin, skin splits, and soot deposition of the airways. The skin splits were predominantly on the forehead, left temple, perioral region, chin, upper chest, bilateral upper extremities, and lower abdomen. There was dense soot in the nares, oral cavity, and trachea, and scant soot in the bilateral mainstem bronchi and proximal esophagus. The muscles, body cavities, and organs had a bright red-pink discoloration. The decedent's carboxyhemoglobin level was elevated at 51.3%. Her cause of death was inhalation of products of combustion and thermal injuries. The fetus had neither trauma nor malformations. Fetal heart carboxyhemoglobin level was 4.9%.

DISCUSSION: The research on what fetal carboxyhemoglobin levels occur at certain maternal carboxyhemoglobin levels is unclear. While there are some studies on chronic maternal exposure to carbon monoxide (mostly through smoking) and paired fetal and maternal carboxyhemoglobin levels, there are very few case studies available regarding acute carbon monoxide toxicity and concurrent maternal and fetal carboxyhemoglobin levels. This case provides insight into this relationship.

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