Botulisme et grossesse

Magri, K.; Bresson, V.; Barbier, Clémentine

doi:10.1016/s0368-2315(06)76453-5

Cited by 10 publications

(1 citation statement)

References 12 publications

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“…Another prospective study looking at the use of OnabotulinumtoxinA for the management of chronic migraine in 45 pregnant patients reported no impact on pregnancy outcomes (4). Additionally, clinical case reports of women affected by botulism illness did not show adverse effects on the pregnancy, including one case where the only notable movement in the patient was the fetus, while the mother was affected by paralysis (5)(6)(7)(8)(9)(10). It is therefore reasonable to assume that, if the naturally occurring botulinum toxin, weighing 150 kDA, does not cross the placental barrier, then the complexed OnabotulinumtoxinA molecule which weighs 900 kDA is even less likely to.…”

Section: Introductionmentioning

confidence: 99%

Safety of OnabotulinumtoxinA in the [management of] chronic migraine in pregnancy

Smirnoff

2022

Front. Pain Res.

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Section: Introductionmentioning

confidence: 99%

Safety of OnabotulinumtoxinA in the [management of] chronic migraine in pregnancy

Smirnoff

2022

Front. Pain Res.

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Botulism

Lonati

Rossetto

Fenicia

et al. 2009

General, Applied and Systems Toxicology

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Botulism is a paralytic illness caused by botulinum neurotoxins (BoNTs) produced by three clostridium species ( Clostridium botulinum, Clostridium butyricum and Clostridium baratii ). Seven immunological BoNTs, (A–G) have been recognized. Human botulism has been mainly caused by type‐A, B, E and rarely by F neurotoxins. BoNT is a simple dichain polypeptide that consists of a 100 kDa ‘heavy’ chain joined by a single disulfide bond to a 50 kDa ‘light’ chain. The toxin's light chain is a Zn 2+ ‐containing endopeptidase that blocks acetylcholine‐containing vesicles from fusing with the terminal membrane of the peripheral cholinergic terminals, resulting in flaccid muscle paralysis and alteration of autonomic functions. Three common and naturally occurring botulism types have been identified: foodborne, wound and intestinal botulism (including infant and adult forms). Two other forms are man‐made: inhalation botulism could result from aerosolization of BoNTs from laboratory accidents or deliberate dissemination, whereas iatrogenic botulism is related to incorrect usage of injected BoNTs for cosmetic or therapeutic purposes. The clinical syndrome is characterized by symmetrical cranial nerve palsies followed by a descending, symmetrical, flaccid paralysis that may progress to respiratory compromise and death. The diagnosis is essentially clinical and can be confirmed by the detection of BoNTs in human or in food samples; in the infant and intestinal forms, BoNTs‐producing Clostridia can be isolated from stools. Current management is based on supportive treatment (including respiratory support in severe cases) and antitoxin administration that, if early practised, may prevent or limit the extent of the paralysis, but will not reverse it.

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Pregnancy outcomes following exposure to onabotulinumtoxinA

Brin

Kirby

Slavotinek

et al. 2015

Pharmacoepidemiol Drug Saf

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PurposeTo evaluate pregnancy outcomes following onabotulinumtoxinA (US Food and Drug Administration pregnancy category C product) exposure using the Allergan safety database.MethodsThe Allergan Global Safety Database contains reports of onabotulinumtoxinA administration before/during pregnancy, including both prospective (reported before outcome) and retrospective (outcome already known) cases. The database was searched from 1/1/90 to 12/31/13 for eligible cases where treatment occurred during pregnancy or ≤3 months before conception. To minimize reporting bias, prevalence rates were focused on prospective cases.ResultsOf 574 pregnancies with maternal onabotulinumtoxinA exposure, 232 were eligible with known outcomes. Patients received onabotulinumtoxinA most frequently for cosmetic indications (50.5%), movement disorders (16.8%), and pain disorders (14.2%). Of the 137 with dose information, 40.1% received <50U, 14.6% 50U to <100U, 27.7% 100U to <200U, and 17.5% ≥200U. Among 146 cases with known maternal age, 47.9% were ≥35 years. Most (96.0%) fetal exposures occurred during/before the first trimester. Of the 137 prospective cases (139 fetuses), 110 (79.1%) were live births; 29 (20.9%; 95% CI, 14.0–30.0%) ended in fetal loss (21 spontaneous, 8 induced abortions). Among live births, 106 (96.4%) were normal, with four abnormal birth outcomes (1 major fetal defect, 2 minor fetal malformations, 1 birth complication), giving a 2.7% (3/110; 95% CI, 0.6–8.0%) prevalence rate for overall fetal defects.ConclusionsA 24‐year retrospective review of the Allergan safety database shows that the prevalence of fetal defects in onabotulinumtoxinA‐exposed mothers before/during pregnancy (2.7%) is comparable with background rates in the general population. Pregnancy outcome monitoring in onabotulinumtoxinA‐exposed women continues. © 2015 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

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Botulisme et grossesse

Cited by 10 publications

References 12 publications

Safety of OnabotulinumtoxinA in the [management of] chronic migraine in pregnancy

Safety of OnabotulinumtoxinA in the [management of] chronic migraine in pregnancy

Botulism

Pregnancy outcomes following exposure to onabotulinumtoxinA

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