Research Information System
4th Regional TIAFT Meeting in Turkey 2022, İstanbul, Turkey, 13 - 15 October 2022, pp.1, (Full Text)
Evaluation of Occupational Exposure to Greenhouse-Agricultural Pesticides In a Pregnant Mother at First Trimester
Ozan Ozturk 1 , Secil Karaca Kurtulmus 2 , Ismail Yilmaz 1
1 Izmir Kâtip Celebi University School of Medicine, Department of Pharmacology and Toxicology, Izmir, Turkey
2 Izmir Kâtip Celebi University School of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey
E-mail: ozanozturk2@gmail.com
Introduction: Exposure to toxic substances during pregnancy makes mother irritated in terms of teratogenicity and can cause serious problems. While clinical data on the teratogenic effects of drugs are available, data on toxic products are limited. In this case, the clinical follow-ups of the pregnant woman who was exposed to toxic Greenhouse pesticides without knowing that she was pregnant in the closed greenhouse environment she worked in was evaluated in terms of maternal health and
foetal development.
Case: A woman (37 years old) who applied to our hospital when she was 12 weeks and 3 days pregnant, worked in an environment where a lot of greenhouse pesticides were used for 5 hours a day, 3 days a week, without mask and protective equipment in the first 8 weeks of pregnancy. Exposed drugs are Cyprodinil+Fludioxonil, Tolclofos methyl, Flonicamid, Spinosad, Gliycine+Betain, Thiram, Pirimicarb, Dimethomorph, Daminozid, Kormequat klorid, Benzyladenine-6, Gibberellin A4/A7+6-benzyladenine, Captan, Tolclofos methyl, Spirotetramat, Chloratraniliprole+Abamectin, Fluopyram+Trifloxystrobin, Sulfoxaflor, Cyantraniliprole and Propiconazol. Low dose acetylsalicylic acid was applied for the pregnant woman due to a history of preeclampsia and Foetal Growth Restriction (FGR) in her previous pregnancy. Due to the increased risk of Trisomy 21 in the first trimester genetic screening test, the result of amniocentesis at 16 weeks was reported as normal karyotype. Gross foetal anomaly was not observed in the foetal anatomical evaluation performed at the 20 th week, but the soft palate could not be evaluated in USG. Chorioamnionitis separation area was observed in the left lateral of the placenta. Alpha-Methyl dopa was applied due to hypertension in the antenatal follow-up at 25 th week. In the last antenatal follow-up at 28 weeks, foetal biometric measurements and Doppler USG findings were normal. In terms of maternal and foetal pregnancy complications related to hypertension and toxic exposures, a biweekly control was recommended.
Conclusion: Teratogens originating from drugs or toxic substances can manifest themselves with FGR, miscarriage, stillbirth and neuro behavioural abnormalities, apart from major minor structural malformations. Occupational exposure-induced toxic substances pass intro the systemic circulation by inhalation, absorption through the skin, contract with the mucous membranes and orally. There are no restricted clinical studies on the exposure and teratogenic effects of greenhouse and pesticides during pregnancy. This makes difficult to risk assessment. Although there are experimental data on some chemicals in pregnant animals, it should be noted that they are not always applicable to humans. It is important to pay more attention to the use of protective equipment and to raise awareness about the use of protective equipment, especially in women of reproductive age, who work in environments where occupational exposure to toxic products are riskier, especially in the first trimester, in terms of the development of organs in the embryo, and pregnancy is often noticed late.
Keywords: Pregnancy; toxins; occupational exposure; teratology; congenital abnormalities