What is Anaphylaxis?
Anaphylaxis is a life-threatening reaction throughout the body that has a sudden onset and results from exposure to a triggering agent, such as a particular food, medication, or insect bite. It can affect multiple organ systems, including skin, the respiratory, gastrointestinal, cardiovascular, and/or central nervous systems. It can be immunologic, meaning due to release of a substance from cells called mast cells and basophils, the release being mediated by an antibody called IgE. The reaction also can be nonimmunologic, which is sometimes called an anaphylactoid reaction. Additionally, anaphylaxis can happen with no identifiable cause (idiopathic anaphylaxis).
How common is anaphylaxis during pregnancy?
Anaphylaxis is rare during pregnancy, but potentially disastrous.
How is anaphylaxis diagnosed?
The diagnosis of anaphylaxis is made based on the patient history and recognition by the examiner of signs and symptoms, such as flushing, itching, hives, swelling around the mouth and eyes, breathing difficulty, wheezing, nasal itching, and chest tightness. During pregnancy, symptoms and signs of anaphylaxis can include itching in the vaginal-vulvar area, lower back pain, uterine cramps, fetal distress, and premature labor. Blood samples can be taken for laboratory testing to confirm the diagnosis, but treatment begins before these test results are available.
Does anaphylaxis cause problems during pregnancy?
Anaphylaxis puts you at risk of brain damage, due to not enough blood reaching the brain, which can lead to death.
Does anaphylaxis during pregnancy cause problems for the baby?
Anaphylaxis can lead to not enough blood reaching the uterus and placenta, leading to premature labor and delivery, or death of the baby.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the anaphylaxis
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat anaphylaxis during pregnancy?
Treatment of anaphylaxis relies greatly on the use of the drug epinephrine. There is some concern that epinephrine could pose some risk to the developing baby, but the baby is in much graver danger from the prospect of maternal death. Since epinephrine is a life-saving measure, there is no scenario in which it should be avoided. Other medications that can be given, also as a matter of life and death, include beta-2 agonists, such as albuterol. Additionally, in some cases, doctors may add the hormone glucagon to increase blood sugar levels, H2 antihistamines (cimetidine, ranitidine), or H1 antihistamines (diphenhydramine).
Who should NOT stop taking medication for anaphylaxis during pregnancy?
As noted above, anaphylaxis is an emergency, so there is no choice about medications if medications are indicated.
What should I know about choosing a medication for my anaphylaxis during pregnancy?
You may find Pregistrys expert reports about the individual medications to treat anaphylaxis here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my anaphylaxis when I am breastfeeding?
Since anaphylaxis is an emergency, medications are given in the short term for the sake of saving the mothers life, so there is really no issue related to breastfeeding. Any long-term medication that you may need to take to prevent further episodes, such as antihistamines, are not particularly dangerous for the nursing baby.
What alternative therapies besides medications can I use to treat my anaphylaxis during pregnancy?
Non-medication measures that are used in addition to medications (but not as alternatives) consist of fluid management (giving the patient fluids intravenously as needed), and future avoidance of agents that can cause another anaphylaxis episode.
What can I do for myself and my baby when I have anaphylaxis during pregnancy?
As noted above, anaphylaxis is an emergency situation, so treatment must be taken immediately.
Resources for anaphylaxis in pregnancy:
For more information about anaphylaxis during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:
- Mayo Clinic: Anaphylaxis
- Cleveland Clinic: Anaphylaxis
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.