First things first: anyone bitten by a rattlesnake should get help right away, even if they do not notice any symptoms. This is the same for people who are pregnant. Symptoms can include pain and swelling at the location of the bite, nausea, swelling in the mouth and throat, having trouble breathing, and /or blood complications (bleeding and problems with clotting). People are advised to not try and treat the bite themselves. Treating a rattlesnake bite quickly and correctly can help lower the chance of complications such as bleeding and blood clots.

Complications

One serious complication from a rattlesnake bite can be the formation of blood clots. In general, people who are pregnant are five times more likely to experience a blood clot compared with people who are not pregnant.^1. Blood clots can change the amount of blood the pregnancy receives. Clots can also break off and travel to the lungs (called a pulmonary embolism) which can be life-threatening. Other complications associated with blood clots include miscarriage, stillbirth, reduced growth of the pregnancy, clots blocking veins or arteries (thrombosis), oxygen and nutrients not passing to the fetus through the placenta (placental insufficiency), changes in blood pressure, preterm delivery (birth before week 37), heart attack, stroke, and death.

Pregnancy outcomes often depend on different factors. Every pregnancy starts out with a 3-5% chance of having a birth defect (called the background risk). Also, miscarriage is common and can occur in any pregnancy for many different reasons. For snake bites in particular, such factors that can affect outcomes include the amount of venom a pregnancy is exposed to, gestational age at the time of the bite, and when treatment is started, how long it lasts, and quality of treatment.

Information on snake bites in pregnancy is limited. There are case reports that describe issues such as hydrocephalus (an abnormal buildup of fluid in the ventricles in the brain), intracranial hemorrhage (bleeding in the skull), reduced fetal movements, placental abruption (when the placenta separates from the inner wall of the uterus before delivery), miscarriage, stillbirth, and maternal death. While case reports do not establish that the snake venom caused these issues, treating a snake bite is important.

Treatment During Pregnancy

Treatment plans for rattlesnake bites in general can include antivenom (an antibody that can work to stop a venom’s toxins) and laboratory testing to monitor how the person’s blood is clotting. When a bite occurs in pregnancy, a healthcare provider may want to monitor fetal movement and / or fetal heart rate.

There are reports of healthy, live births after treatment with antivenom. Though information on rattlesnake bites and the use of antivenom during pregnancy is limited, the benefits of treating a rattlesnake bite with antivenom are expected to outweigh the risks of untreated illness during pregnancy. The few reports of follow up on infants exposed to antivenom during pregnancy have not suggested any long-term medical concerns.

Rattlesnake bites in pregnancy are a serious exposure that should receive medical attention right away. It is true that there are things about rattlesnake bites in pregnancy for which we have limited information, including the use of antivenom. However, treatment and monitoring are likely going to be recommended in order to protect the health of the person who is pregnant and the health of the pregnancy. More information on rattlesnake bites can be found at the Arizona Poison and Drug Information Center website here.

References:

Centers for Disease Control and Prevention (2022). Pregnant? Don’t overlook blood clots. Published June 9, 2022. Accessed July 26, 2022.

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