Maternal anaphylactic shock in pregnancy: A case report
- Abstract
- Rationale: Anaphylaxis is a very rare event in pregnancy, triggering maternal hypotension leading to intrapartum hypoxic-ischemic
encephalopathy in infant. Furthermore, cesarean sections are performed at a high rate in anaphylactic pregnant women.
Patient concerns: A 34-year-old pregnant woman presented with maternal anaphylaxis following prophylactic antibiotic injection
for cesarean section. Within a few minutes after initiation of intradermal skin test with cefotetan, the pregnant woman developed
generalized itchy rash, chest tightness, and dyspnea.
Diagnoses: Several minutes after the injection of antibiotics, a diffuse urticarial rash was detected over her face and trunk followed
by complaints of chest tightness and dyspnea. She was diagnosed with hypotension and hypoxia. Further, fetal heart tones showed
bradycardia. A presumptive diagnosis of anaphylactic reaction induced by cefotetan was made for surgical prophylaxis.
Interventions: The patient was managed for anaphylaxis, via administration of epinephrine, glucocorticoid, and antihistamine.
Emergency cesarean section performed under general anesthesia resulted in a favorable perinatal outcome for the fetus.
Outcomes: Maternal and fetal outcomes were good after prompt treatment for anaphylaxis and emergency cesarean section.
Lessons: This is the first reported case of anaphylaxis following cefotetan administration in pregnancy. Cefotetan, a secondgeneration cephalosporin, is a commonly prescribed antibiotic used to treat a wide range of bacterial infections. The case
demonstrated life-threatening anaphylactic reaction during pregnancy. Even a skin test using antibiotics alone triggered anaphylaxis.
- All Author(s)
- H. J. Jeon
; A. Ryu
; J. Min
; N. S. Kim
- Issued Date
- 2018
- Type
- Article
- Keyword
- anaphylaxis; cefotetan; fetal distress; pregnancy; surgical prophylaxis
- Publisher
- Lippincott Williams & Wilkins
- ISSN
- 0025-7974
; 1536-5964
- Citation Title
- Medicine
- Citation Volume
- 97
- Citation Number
- 37
- Citation Start Page
- e12351
- Citation End Page
- e12351
- Language(ISO)
- eng
- DOI
- 10.1097/md.0000000000012351
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2433
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