{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:18:35Z","timestamp":1774621115129,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Obstetrics and Gynecology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Snakebite envenomation (SBE) is a tropical disease with significant global morbidity and mortality, particularly affecting low\u2010resource settings. During pregnancy, SBE poses unique challenges, increasing both maternal and fetal mortality. Limited access to antivenom and delayed treatment further worsen outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      We report the case of a 36\u2010year\u2010old pregnant woman at 40.6 weeks gestation who presented to a rural Ecuadorian health center following a\n                      <jats:italic>Bothrops<\/jats:italic>\n                      snakebite to the right hand. Coagulopathy was detected and initially managed with antivenom. Because of fetal distress and oligohydramnios, an urgent cesarean section was performed. The patient subsequently developed severe postpartum hemorrhage secondary to venom\u2010induced coagulopathy (VICC), requiring subtotal hysterectomy, intensive care, and further antivenom administration. Postoperative recovery was favorable, and the patient was discharged in stable condition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates the complex pathophysiology of viper envenomation, including systemic coagulopathy, uterine atony, and thrombin\u2010induced postpartum hemorrhage. It highlights the diagnostic challenges, the limitations of standard coagulation tests in VICC, and the importance of early antivenom therapy. Delayed treatment in rural areas contributes significantly to maternal\u2010fetal morbidity. Obstetric complications such as placental abruption, fetal hypoxia, and hemorrhage must be anticipated in SBE during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Timely antivenom administration and multidisciplinary management are essential to improve outcomes in pregnant patients with SBE. This case emphasizes the need for increased access to antivenom, improved diagnostic tools, and specialized obstetric care in resource\u2010limited regions affected by venomous snakebites.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crog\/1956143","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:29:36Z","timestamp":1772990976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case Report of Postpartum Hemorrhage Secondary to Snake Bite Envenomation: A Pathogenesis and Current Management Review"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8124-0011","authenticated-orcid":false,"given":"Felipe","family":"Loza-Hernandez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Haro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Carri\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Homero","family":"Loza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_2_9_1_2","volume-title":"Envenenamiento por mordedura de serpiente","author":"Organizaci\u00f3n Mundial de la Salud","year":"2023"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.33132\/27114260.1906"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.22490\/24629448.1715"},{"key":"e_1_2_9_4_2","first-page":"17","article-title":"An\u00e1lisis epidemiol\u00f3gico y cl\u00ednico de intoxicaciones agudas atendidas en Monter\u00eda, Colombia","volume":"21","author":"Guzm\u00e1n Ter\u00e1n C.","year":"2015","journal-title":"Revista M\u00e9dica de Risaralda"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.33132\/27114260.1906"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.36829\/63CTS.V3I2.112"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0489-2017"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.TOXCX.2020.100037"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/TOXINS11060363"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.WEM.2009.12.025"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PNTD.0010963"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1191\/0960327105HT535OA"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/NRDP.2017.63"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PNTD.0001255"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/TOXINS8040093"},{"key":"e_1_2_9_16_2","volume-title":"Le\u00e7ons sur le Venin des Serpents du Br\u00e9sil et sur la M\u00e9thode de Traitement des Morsures Venimeuses par le Permanganate de Potasse","author":"LaCerda J.","year":"1884"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.TOXLET.2018.02.004"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/A-2407-1400"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.CBPC.2005.11.005"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007041"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PNTD.0008936"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/TOXINS15090530"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/toxins11030148"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/toxins14010057"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1590\/1678-9199-JVATITD-2019-0076"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.TOXICON.2014.04.001"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003220"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2021.1948559"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X20952640"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJGO.2008.03.006"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002351"},{"key":"e_1_2_9_32_2","volume-title":"Regional OFfice in South-East Asia. 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