Addiction to 'Gul' and 'Gutkha' Leading to Acute Pulmonary Thrombosis and Acute Psychosis in a Young Pregnant Lady

Abstract

Gul is an oral tobacco powder which is rubbed over the gum and teeth. Being a tobacco preparation it is addictive in nature. It is popular among rural women in the south Asian countries. Not much is known about long term of gul on atherogenesis and/or pregnancy. Gul alone may or may not exert harmful effect on future course of pregnancy, however when combined with another tobacco preparation 'gutkha' which contains tobacco and betel nut, it may be dangerous for the foetus as well as for the mother. So far little has been reported regarding the atherogenic potential of gul and gutkha during pregnancy. We recently came across a young pregnant lady who was addicted to gul and gutkha for long. She developed acute pulmonary thrombosis during 32th week of pregnancy and had previous two episodes of abortions. Her thrombophilic profile was normal. The pulmonary thrombosis resolved after preterm delivery and anticoagulant therapy. However, she developed acute craving for gul and gutkha and acute psychosis on 5th day of delivery which responded to antipsychotic regimen. Present case highlights the highly addictive and potentially atherogenic effects of gul, considered innocuous by users. The case focuses the catastrophic effect of gul and gutkha which may lead to thrombophilic state when taken during pregnancy.




J Med Cases. 2010;1(1):35-36
doi: https://doi.org/10.4021/jmc7w