Objective: To present the first reported case of premature labor complicating severe red-back spider envenomation and the use of antivenom in its treatment.
Clinical features: A 33 year old multiparous woman, 30 weeks pregnant, arrived at hospital almost a day after being bitten. She displayed classical features of red-back spider envenomation and was having regular, moderately strong, uterine contractions. She had a history of premature labor with previous pregnancies.
Intervention: She was treated initially with red-back spider antivenom followed shortly afterwards by an indomethacin suppository. This markedly improved her symptoms of envenomation and significantly reduced the strength and frequency of uterine contractions. A second ampoule of antivenom with another indomethacin suppository all but resolved the patient's clinical problems. She was discharged without sequelae.
Data synthesis: Medline search was undertaken for reports of the complications of Latrodectus envenomation in pregnancy.
Conclusion: Premature labor is a rare complication of red-back spider envenomation. Antivenom is a safe and essential part of its management.