Heavy metals detected in fetal and placental tissues in a pregnancy complicated by severe fetal growth impairment and sacrococcygeal teratoma: a case report

Protecting the health of pregnant workers is a critical public health and occupational priority. This case report describes a textile industry worker with long-term occupational chemical exposure whose pregnancy was complicated by severe fetal malformations leading to termination; a subsequent multidisciplinary reassessment supported an occupationally mediated contributory role. The potential environmental/occupational contribution was not recognised during the initial routine clinical work-up and was identified only retrospectively through integrated toxicology, pathology, occupational medicine, and forensic evaluation. A distinctive aspect of the case was the application of an innovative technique to detect toxicants in formalin-fixed, paraffin-embedded (FFPE) tissue samples years after the initial events, expanding the possibilities for retrospective environmental exposure assessment. Additionally, the cooccurrence of a sacrococcygeal teratoma (SCT) is discussed as a hypothesisgenerating observation in the context of possible occupational exposure. This case underscores the importance of comprehensive occupational health surveillance during pregnancy, the integration of environmental exposure assessment into prenatal care, and highlights the potential regulatory and occupational-health implications of inadequate protection of pregnant workers