EXPOSURE TO FLUOROACETATES IN PREGNANCY

Fluoroacetic acid derivatives (organofluorines) such as sodium fluoroacetic acid, methyl fluoroacetic acid and fluoroacetamide have been used as rodenticides.  Occupational exposure can occur in formulators and pest control workers.  Due to their extreme toxicity the use of these compounds is not widespread.  Fluoroacetic acid derivatives dissociate to yield the fluoroacetate anion which is converted to fluorocitrate, inhibiting the Krebs cycle.

Animal studies have shown adverse effects following exposure to sodium fluoroacetic acid during gestation, with reports of congenital malformations in exposed fetuses.

There are no human data following acute exposure to fluoroacetate compounds during pregnancy, and therefore an accurate evidence-based risk assessment is not possible. Maternal toxicity is likely to be a major determinant of risk to the fetus and if exposure occurs, treatment should be as for a non-pregnant person.  The need for additional fetal monitoring should be considered on a case-by-case basis, even in the absence of maternal toxicity.  Discussion with UKTIS is recommended in all cases.  Other risk factors may also be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case specific risk assessments.