Zinc Phosphide Poisoning in Pregnancy: A Rare Case Report From Nepal

Zinc phosphide (Zn₃P₂) poisoning during pregnancy is exceedingly unusual and potentially lethal, with no previously known occurrences globally. We present a 26-year-old woman, gravida 2 para 1, at 29 weeks gestation, who took 15 g of Zn₃P₂ in a suicidal attempt and experienced non-projectile vomiting. Her vital signs were stable (BP 110/80 mmHg, GCS 15/15), but she experienced transitory hepatic dysfunction that improved on Day 4 with supportive therapy such as coconut oil gastric lavage, intravenous fluids, and pantoprazole. The fetal scan confirmed viability (heart rate of 158 bpm). The high mortality of Zn₃P₂ (37%-100%) is caused by phosphine gas-induced suppression of mitochondrial respiration. This case emphasizes the lack of a particular antidote and the significance of immediate decontamination, hepatic monitoring, and mental follow-up following purposeful consumption.