{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:52:41Z","timestamp":1781704361679,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Brodifacoum is a highly potent superwarfarin rodenticide that leads to coagulopathy. Although the effect of warfarin during pregnancy is well understood, reports on superwarfarin poisoning, like brodifacoum, during pregnancy are scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>We report a case involving a woman with a singleton pregnancy who experienced sudden nasal hemorrhage accompanied by hematuria at 34\u00a0weeks and 3\u00a0days of gestation, with no apparent etiology. It was ultimately diagnosed as acquired coagulopathy resulting from brodifacoum poisoning. Fetal ultrasonography revealed significant intracranial hemorrhage, leading to intrauterine fetal demise and subsequent pregnancy termination. Following the correction of the patient\u2019s coagulation profile through intravenous and oral administration of vitamin K1, tailored to the serum levels of brodifacoum, diligent monitoring confirmed that the patient was in stable condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The primary hazard associated with the ingestion of brodifacoum is hemorrhage, with clinical presentations varying from asymptomatic cases to overt bleeding, which may present as hematuria, epistaxis, menometrorrhagia, and intracranial hemorrhage. Therefore, the diagnosis and management of this type of poisoning pose significant challenges. Prompt recognition and ongoing care for pregnant individuals affected by rodenticide toxicity are crucial for optimizing maternal health outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2024.1502596","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T04:22:59Z","timestamp":1732681379000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute long-acting anticoagulant rodenticide poisoning in pregnancy: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Yanxi","family":"Jia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongchi","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiqiong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1378\/chest.102.4.1301","article-title":"Diffuse alveolar hemorrhage secondary to superwarfarin ingestion","volume":"102","author":"Barnett","year":"1992","journal-title":"Chest"},{"key":"B2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41572-021-00278-x","article-title":"Haemophilia","volume":"7","author":"Berntorp","year":"2021","journal-title":"Nat. Rev. Dis. Primer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1067\/mem.2000.108317","article-title":"Long-acting anticoagulant overdose: brodifacoum kinetics and optimal vitamin K dosing","volume":"36","author":"Bruno","year":"2000","journal-title":"Ann. Emerg. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1097\/AOG.0000000000002706","article-title":"ACOG practice bulletin No. 196: thromboembolism in pregnancy","volume":"132","year":"2018","journal-title":"Obstet. Gynecol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1922.e3","DOI":"10.1016\/j.ajem.2018.06.040","article-title":"Fixed dose 4-factor prothrombin complex concentrate for bleeding caused by long acting anticoagulant rodenticides","volume":"36","author":"Doyle","year":"2018","journal-title":"Am. J. Emerg. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/MBC.0b013e328358e959","article-title":"I smell a rat: a case report and literature review of paradoxical thrombosis and hemorrhage in a patient with brodifacoum toxicity","volume":"24","author":"Franco","year":"2013","journal-title":"Blood Coagulation and Fibrinolysis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3109\/15563650.2011.587126","article-title":"Management of intentional superwarfarin poisoning with long-term vitamin K and brodifacoum levels","volume":"49","author":"Gunja","year":"2011","journal-title":"Clin. Toxicol. (Phila)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"116.e1","DOI":"10.1016\/j.ajem.2015.05.033","article-title":"Superwarfarin ingestion treated successfully with prothrombin complex concentrate","volume":"234","author":"Haesloop","year":"2016","journal-title":"Am. J. Emerg. Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.tmrv.2015.06.002","article-title":"Long-acting anticoagulant rodenticide (superwarfarin) poisoning: a review of its historical development, epidemiology, and clinical management","volume":"29","author":"King","year":"2015","journal-title":"Transfus. Med. Rev."},{"key":"B10","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.ogc.2018.01.007","article-title":"Thromboprophylaxis in pregnancy","volume":"45","author":"Kolettis","year":"2018","journal-title":"Obstet. Gynecol. Clin. North Am."},{"key":"B11","doi-asserted-by":"publisher","first-page":"137792","DOI":"10.1016\/j.foodchem.2023.137792","article-title":"A facile fluorescence microplate immunoassay based on an in situ fluorogenic reaction for the detection of two highly toxic anticoagulant rodenticides in food and biological matrix","volume":"437","author":"Li","year":"2024","journal-title":"Food Chem."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3004","DOI":"10.1001\/jama.1984.03350210052030","article-title":"Human ingestion of a \u201csuperwarfarin\u201d rodenticide resulting in a prolonged anticoagulant effect","volume":"252","author":"Lipton","year":"1984","journal-title":"JAMA"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e8506","DOI":"10.1097\/MD.0000000000008506","article-title":"Massive neonatal intracranial hemorrhage caused by bromadiolone: a case report","volume":"96","author":"Ma","year":"2017","journal-title":"Med. Baltim."},{"key":"B14","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1097\/AOG.0b013e31829267c4","article-title":"Lethal neonatal coagulopathy after maternal ingestion of a superwarfarin","volume":"122","author":"Mehlhaff","year":"2013","journal-title":"Obstet. Gynecol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"607","DOI":"10.15585\/mmwr.mm6721a4","article-title":"Notes from the field: outbreak of severe illness linked to the vitamin K antagonist brodifacoum and use of synthetic cannabinoids-Illinois, March\u2013April 2018","volume":"67","author":"Moritz","year":"2018","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"B16","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.forsciint.2006.04.003","article-title":"Lethal paradoxical cerebral vein thrombosis due to suspicious anticoagulant rodenticide intoxication with chlorophacinone","volume":"166","author":"Papin","year":"2007","journal-title":"Forensic Sci. Int."},{"key":"B17","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s40268-019-0261-4","article-title":"Should cytochrome P450 inducers be used to accelerate clearance of brodifacoum from poisoned patients?","volume":"19","author":"Rubinstein","year":"2019","journal-title":"Drugs R. D."},{"key":"B18","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1080\/24734306.2018.1500152","article-title":"Treatment for long acting anticoagulant rodenticide poisoning-beyond INR monitoring?","volume":"2","author":"Rubinstein","year":"2018","journal-title":"Toxicol. Commun."},{"key":"B19","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1542\/peds.84.3.490","article-title":"Superwarfarin poisoning in children: a prospective study","volume":"84","author":"Smolinske","year":"1989","journal-title":"Pediatrics"},{"key":"B20","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.bpobgyn.2019.10.007","article-title":"Medications in pregnancy and breastfeeding","volume":"64","author":"Tosounidou","year":"2019","journal-title":"Best. Pract. Res. Clin. Obstet. Gynaecol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1592\/phco.23.10.1186.32755","article-title":"Superwarfarin and glass ingestion with prolonged coagulopathy requiring high-dose vitamin K1 therapy","volume":"23","author":"Tsutaoka","year":"2003","journal-title":"Pharmacotherapy"},{"key":"B22","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1093\/jat\/34.5.273","article-title":"Analysis of multiple anticoagulant rodenticides in animal blood and liver tissue using principles of QuEChERS method","volume":"34","author":"Vudathala","year":"2010","journal-title":"J. Anal. Toxicol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.ijgo.2013.03.008","article-title":"Vitamin K treatment of brodifacoum poisoning in a pregnant woman","volume":"122","author":"Yan","year":"2013","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1016\/j.mayocp.2019.05.007","article-title":"Pregnancy in women with life-threatening poisoning with long-acting anticoagulant rodenticides","volume":"94","author":"Yaqoob","year":"2019","journal-title":"Mayo Clin. Proc."},{"key":"B25","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1016\/s0029-7844(97)00408-0","article-title":"Pregnancy outcome after maternal poisoning with brodifacoum, a long-acting warfarin-like rodenticide","volume":"90","author":"Zurawski","year":"1997","journal-title":"Obstet. Gynecol."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1502596\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T04:23:02Z","timestamp":1732681382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1502596\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,27]]},"references-count":25,"alternative-id":["10.3389\/fphar.2024.1502596"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2024.1502596","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,27]]},"article-number":"1502596"}}