Management of maternal anaphylaxis in pregnancy: a case report

Case A 26-year-old woman (gravida 2, para 1) at 25 weeks’ gestation was brought to the emergency department because of anaphylactic symptoms. She reported eating Japanese soba and developed symptoms of dyspnea, generalized itchy rash, abdominal pain, and severe uterine contractions within 15–30 min of eating. She was immediately treated by normal saline infusion, two injections of epinephrine (intramuscularly), and a nebulized short-acting β2-receptor agonist, followed by H1-antihistamine and methylprednisolone. Obstetrical management was undertaken by an obstetrician. Outcome The patient recovered rapidly without a biphasic reaction of anaphylaxis. After 11 weeks, a healthy, neurologically intact baby was born. Conclusion Management of anaphylaxis in pregnant patients is basically the same of that in non-pregnant ones. Treatment should commence immediately to prevent further development of the anaphylaxis reaction and fetal neurological deficiency.