Electric shock in pregnancy - query bank

Question: A 27 year old primigravida presented at 40+5 weeks following an electric shock from a 220V household light switch which was loose following building work. She had not fallen or lost consciousness and had no point of entry injury. Clinical examination was normal and maternal ECG and fetal CTG were both reassuring. What are the fetal effects of accidental electric shock in pregnancy?

This clinical query answer was produced by RCOG Library staff following the clinical query protocol as described here.

Answer:

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A similar question was answered by the Motherisk programme in Canada in 2003 (Goldman), which found "conflicting reports on how harmful electric shock is to a fetus. The clinical spectrum of electrical injury ranges from a transient unpleasant sensation felt by a mother and no effect on her fetus to fetal death either immediately or few days later."

A PatientPlus article on Electrical Injuries and Lightning Strikes says:

  • "General points: there is little information available about electric shocks during pregnancy and the accepted high rate of mortality may be due to publication bias. However, it is well documented that fetal skin is 200 times less resistant than the skin postnatally, so less electricity may cause significantly more harm. Indeed, an amount enough to cause minimal injury to the mother may be lethal to the fetus. Furthermore, the path of transmission becomes important here: the current path may completely bypass the maternal heart but, if it travels through the uterus, the fetus may be seriously injured.
  • Fetal harm: other than cardiac arrest, fetal complications include intrauterine growth restriction, oligohydramnios, reduction in fetal movements and spontaneous abortion."

Additional case reports were identified of renal vein thrombosis (Anguenot, Djeddi), and early infantile epileptic encephalopathy (Krasemann) 

(Evidence level III)

References:

  • Anguenot JL. Antenatal renal vein thrombosis after accidental electric shock in a pregnant woman. Journal of Ultrasound in Medicine. 18(11):779-81, 1999 Nov.
  • Djeddi D. Leke AL. Al-Hosri J. Kilani L. Gondry J. Boudailliez B. Krim G. [Neonatal renal venous thrombosis following an electrical shock in pregnancy]. [French] Original Title: Thrombose neonatale de la veine renale suite a une electrisation in-utero accidentelle. Archives de Pediatrie. 12(1):42-5, 2005 Jan. Abstract
  • Goldman RD. Einarson A. Koren G. Electric shock during pregnancy. Canadian Family Physician. 49:297-8, 2003 Mar.
  • Krasemann T. Hoovey S. Uekoetter J. Bosse H. Kurlemann G. Debus OM. Early infantile epileptic encephalopathy (Ohtahara syndrome) after maternal electric injury during pregnancy: etiological considerations. Brain & Development. 23(5):359-62, 2001 Aug. Abstract
  • PatientPlus. Electrical Injuries and Lightning Strikes. 2011

Search date: April 2012

Classification of evidence levels

Ia Evidence obtained from meta-analysis of randomised controlled trials.

Ib Evidence obtained from at least one randomised controlled trial.

IIa Evidence obtained from at least one well-designed controlled study without randomisation.

IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.

III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.

IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.

 

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Date published: 03/04/2012

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