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Am J Emerg Med. 2008 Jul;26(6):735.e1-2. doi: 10.1016/j.ajem.2007.11.017.

Caring for the mother, concentrating on the fetus: intravenous N-acetylcysteine in pregnancy.

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Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA 98431, USA.


Acetaminophen is one of the most common toxicities in pregnancy, thus providers should be aware of treatment options. We use a case presentation to demonstrate the successful use of a 20-hour protocol of intravenous N-acetylcysteine. A 26-year-old woman, gravid3para1102, at an estimated gestational age of 32 weeks 2 days presented with a reported ingestion of 9.75 g of acetaminophen 1.5 hours before arrival. The patient was treated with activated charcoal and intravenous N-acetylcysteine. After brief inpatient admission and management, the patient went on to deliver a full-term infant without further sequelae. Acetaminophen toxicity in pregnancy can be treated successfully with intravenous N-acetylcysteine if used in a timely manner with minimal adverse affects on the fetus and mother.

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