Document Detail

Anaphylaxis in the clinical setting of obstetric anesthesia: a literature review.
MedLine Citation:
PMID:  24257386     Owner:  NLM     Status:  In-Data-Review    
The prevalence of anaphylaxis occurring during pregnancy is approximately 3 cases per 100,000 deliveries. The management of anaphylaxis occurring during the third trimester of pregnancy may be challenging because of the additive effects of aortocaval compression and cardiovascular disturbances of anaphylaxis. In this review, we identify the clinical signs of anaphylaxis occurring during labor and cesarean delivery, discuss the more common allergens that cause anaphylaxis during this clinical setting, and develop a rational approach to the identification of the offending allergen. We also suggest strategies for the management of anaphylaxis occurring during the third trimester of pregnancy, including the prompt administration of epinephrine and emergency cesarean delivery in cases of severe reactions. Evidence is limited to case reports and extrapolation from nonfatal and fatal cases, interpretation of pathophysiology, and consensus opinion.
David L Hepner; Mariana Castells; Claudie Mouton-Faivre; Pascale Dewachter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  117     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1357-67     Citation Subset:  AIM; IM    
From the *Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; †Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; ‡Pôle d'Anesthésie-Réanimation & Consultation d'Allergo-Anesthésie, Centre Hospitalier Universitaire, Nancy, France; and §Service d'Anesthésie-Réanimation Chirurgicale, Hôpital Européen Georges Pompidou and Université Paris Descartes Sorbonne Paris Cité, Paris, France.
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