{
  "abstract": "Introduction and importance:: Long-acting anticoagulant rodenticide poisoning during pregnancy is extremely rare but potentially catastrophic. Bromadiolone, a highly lipophilic superwarfarin, crosses the placenta and can cause fetal coagulopathy.\n\nCase presentation:: A 19-year-old primigravida at 37 weeks of gestation presented with abdominal pain and fetal distress. Ultrasound showed mild fetal ventriculomegaly and pleural and pericardial effusions. An emergency cesarean delivery was performed for a Category III fetal heart rate tracing. The neonate died shortly after birth, with copious bright red blood observed in the airway during intubation. Postoperatively, the mother developed profound coagulopathy (PT >150 s, unmeasurable INR, prolonged aPTT) with preserved platelet count and fibrinogen. Repeated history-taking revealed intentional ingestion of bromadiolone bait 12 days earlier. She was treated successfully with fresh frozen plasma and prolonged vitamin K1 therapy.\n\nClinical discussion:: Marked PT/aPTT prolongation with normal platelet count and fibrinogen supported acquired vitamin K-dependent factor deficiency rather than obstetric DIC. Although toxicological confirmation and autopsy were unavailable, the exposure history, coagulation pattern, neonatal airway bleeding, and response to vitamin K1 strongly supported bromadiolone-associated coagulopathy with suspected severe perinatal hemorrhage.\n\nConclusion:: LAAR poisoning should be considered in pregnant patients with unexplained severe coagulopathy and a preserved platelet count and fibrinogen levels. Delayed fetal compromise may occur even when maternal symptoms are minimal. Early multidisciplinary management, prolonged vitamin K1 therapy, and psychosocial support are important.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Obstetrics and Gynecology, Hangzhou Xiaoshan Second People’s Hospital, Hangzhou, Zhejiang, China",
    "Department of Science and Education, Hangzhou Xiaoshan Second People’s Hospital, Hangzhou, Zhejiang, China",
    "Department of Pediatrics, Hangzhou Xiaoshan Second People’s Hospital, Hangzhou, Zhejiang, China"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhiyan Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Meifeng Shen"
    },
    {
      "affs": [
        1
      ],
      "name": "Chenyang Ma",
      "orcid": "0000-0003-0498-9592"
    },
    {
      "affs": [
        2
      ],
      "name": "Huifei Kong"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4g2a1hv54aezx.bib",
  "cited_by": 0,
  "doi": "10.1097/rc9.0000000000001043",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13747500/",
  "id": "4g2a1hv54aezx",
  "issns": [
    "2210-2612"
  ],
  "landing_url": "https://doi.org/10.1097/rc9.0000000000001043",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
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      "openalex",
      "2711|Poisoning and overdose treatments"
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  "openalex": "W7225749674",
  "pdf_url": "https://europepmc.org/articles/PMC13747500?pdf=render",
  "pmcid": "PMC13747500",
  "pmid": "43005806",
  "published": "2026-10-07",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/4g2a1hv54aezx.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T12:23:33Z",
      "native_id": "PMC13747500",
      "source": "pmc",
      "url": "https://doi.org/10.1097/rc9.0000000000001043"
    },
    {
      "first_seen": "2026-11-12T15:22:43Z",
      "native_id": "MED:43005806",
      "source": "europepmc",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2711|Poisoning and overdose treatments",
      "subfield": "general"
    }
  ],
  "title": "Severe fetal hemorrhage and maternal coagulopathy following intentional bromadiolone ingestion in late pregnancy: a case report",
  "title_text": "Severe fetal hemorrhage and maternal coagulopathy following intentional bromadiolone ingestion in late pregnancy: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:24:32Z",
  "url": "https://research.draconitic.com/paper/4g2a1hv54aezx",
  "venue": "International Journal of Surgery Case Reports",
  "versions": []
}