A patient receiving carefully monitored lithium carbonate therapy in late pregnancy developed a toxic condition during the delivery process, apparently due to hemodynamic or metabolic alterations or both, as no additional lithium carbonate was given. Massive diuresis was effective treatment. The infant also had elevated serum lithium ion levels with the clinical signs of cyanosis and flaccid muscle tone.
Both mother and infant have recovered without obvious permanent damage. Extreme caution should be used with lithium carbonate therapy in late pregnancy until further data can be obtained on the maternal-fetal relationship. The promise of effective therapy must be weighed with therapeutic benefit.
Wilbanks GD, Bressler B, Peete CH, Cherny WB, London WL. Toxic Effects of Lithium Carbonate in a Mother and Newborn Infant. JAMA. 1970;213(5):865–867. doi:10.1001/jama.1970.03170310143052
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