Anaphylaxis During Pregnancy

Many women of child-bearing age have asthma and allergies. These conditions can worsen and new allergies can develop during pregnancy, and women who have never had an allergic reaction before may experience anaphylaxis – a severe, whole-body, life-threatening allergic reaction that includes breathing and circulatory problems.

Anaphylaxis is rare during pregnancy, but, if it occurs, it can be devastating to both mother and baby. Anaphylaxis can cause brain damage and it can be fatal to mom and baby. Most of the negative outcomes of anaphylaxis harm the fetus more than the mother.

Causes of anaphylaxis in pregnant women are the same as those in non-pregnant women: things like foods, medications, latex, insects, and pollens are common allergens (substances that cause the body’s immune system to over-react). During labor and delivery, antibiotics and latex exposure are the main causes of anaphylaxis.

Anaphylaxis: how do you know?

Most allergic reactions, including anaphylaxis, do not occur after the first exposure to a substance: they will occur after a second or later exposure, so you may not even realize you have an allergy. Once you have an allergic reaction, however, another is likely to occur every time you are exposed to the offending allergen.

Anaphylaxis always has a rapid onset (it can be as soon as a few seconds but usually 5 to 30 minutes) and a fast progression of symptoms.

Signs and symptoms of anaphylaxis are:

  • Red rash and hives
  • Swelling of the throat of other areas of the body
  • Rapid, weak pulse
  • Wheezing, cough, and trouble breathing
  • Dizziness or fainting
  • Chest pain or tightness
  • Hoarse voice
  • Trouble swallowing
  • Nausea and/or vomiting
  • Diarrhea
  • Stomach cramps
  • Change in color of face or body (such as red or extremely pale)
  • Feeling of impending doom

Symptoms of anaphylaxis during pregnancy may also include intense itching (including vulvar and vaginal itching), low back pain, uterine cramps, fetal distress, and preterm labor. During an anaphylactic reaction, a mother may experience an extreme drop in blood pressure, which means that vital organs – her own and her baby’s – are not getting the oxygen they need.

If you are having any of these symptoms, seek emergency help right away.

Anaphylaxis: what to do

Epinephrine (also known as adrenaline) is the best treatment for anaphylaxis. It is available in pre-fill syringes (sold under the brand name “Epi-Pens”) that people can administer themselves in the event of a severe allergic reaction. Pregnant women who experience anaphylaxis should receive epinephrine as soon as the reaction is identified. Cardiopulmonary resuscitation and emergency cesarean delivery may be required.

The best way to treat any allergy is to avoid known triggers and allergens. Depending on the allergy, you may want to discuss taking a daily allergy medication with your doctor or carrying an Epi-Pen with you at all times.

Women who know they are at risk for an allergic reaction, especially those who have experienced anaphylaxis before, should talk to their health care providers about how to avoid (and treat) serious allergic reactions during pregnancy.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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