Anaphylaxis during pregnancy

Slides:

Advertisements

Similar presentations

D-dimer: A biomarker for antihistamine-resistant chronic urticaria

Advertisements

Mark S. La Shell, MD, Christopher W. Calabria, MD, James M. Quinn, MD

Peter Vadas, MD, PhD, Boris Perelman, PhD, Gary Liss, MD, MS

Anaphylaxis: Recent advances in assessment and treatment

Prospective Evaluation of an Anaphylaxis Education Mini-Handout: The AAAAI Anaphylaxis Wallet Card Vivian Hernandez-Trujillo, MD, FAAAAI, F. Estelle.

Allergen immunotherapy: A practice parameter third update

High-titer IgE antibody specific for pollen allergens in northern California is associated with both wheezing and total serum IgE Elizabeth A. Erwin,

Kyoung-Bok Min, MD, PhD, Jin-Young Min, PhD

Advances in food allergy in 2015

Santa Jeremy Ono, BA, PhD, Mark B. Abelson, MD

F. Estelle R. Simons, MD, FAAAAI, Hugh A. Sampson, MD, FAAAAI

Dennis K. Ledford, MD, Sally Wenzel, MD

Julie Wang, MD, James H. Godbold, PhD, Hugh A. Sampson, MD

World Allergy Organization anaphylaxis guidelines: Summary

Dorothy M. Ryan, MD, Stephen J. Fowler, MD, Robert M. Niven, MD

Incident asthma and Mycoplasma pneumoniae: A nationwide cohort study

Is 9 more than 2 also in allergic airway inflammation?

Sublingual epinephrine tablets versus intramuscular injection of epinephrine: Dose equivalence for potential treatment of anaphylaxis Mutasem M. Rawas-Qalaji,

Desensitization to Chemotherapeutic Agents

An Infant with Atopic Dermatitis and Itching After Ingestion of Milk

NAEPP Expert Panel Report

Keith J. Simons, PhD, Margherita Strolin Benedetti, PhD, F. Estelle R

Lieuwe D. Bos, MSc, PhD, Peter J. Sterk, MD, PhD, Stephen J

Hypersensitivity reactions to chemotherapy: Outcomes and safety of rapid desensitization in 413 cases Mariana C. Castells, MD, PhD, Nichole M. Tennant,

Management of post–liver transplant–associated IgE-mediated food allergy in children Ghyath Maarof, MD, PhD, Roman Krzysiek, MD, PhD, Jean-Luc Décline,

Treatment of chronic autoimmune urticaria with omalizumab

Nonadherence to Asthma Treatment: Getting Unstuck

Peter M. Wolfgram, MD, David B. Allen, MD

Etiology of asthma exacerbations

Cesarean delivery, preterm birth, and risk of food allergy: Nationwide Swedish cohort study of more than 1 million children Niki Mitselou, MD, Jenny.

Asthma treatment and asthma prevention: A tale of 2 parallel pathways

Repeated Episodes of Anaphylaxis with Normal Serum Tryptase but Elevated Levels of Urinary Prostaglandin D2 Phillip Lieberman, MD The Journal of Allergy.

Prospective Evaluation of an Anaphylaxis Education Mini-Handout: The AAAAI Anaphylaxis Wallet Card Vivian Hernandez-Trujillo, MD, FAAAAI, F. Estelle.

Phillip Lieberman, MD, Michael Tankersley, MD

Time for a paradigm shift in asthma treatment: From relieving bronchospasm to controlling systemic inflammation Leif Bjermer, MD Journal of Allergy.

Phillip Lieberman, MD, David Golden, MD

Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management Scott H. Sicherer, MD, Hugh A. Sampson, MD Journal.

Peter Vadas, MD, PhD, Boris Perelman, PhD, Gary Liss, MD, MS

Effect of ingested H1 antihistamines on methacholine challenge

What is an “eosinophilic phenotype” of asthma?

Cephalosporin Side Chain Cross-reactivity

Immune responses to mosquito saliva in 14 individuals with acute systemic allergic reactions to mosquito bites Zhikang Peng, MD, Andrew N. Beckett, BSc,

H. William Kelly, PharmD Journal of Allergy and Clinical Immunology

Cockroach allergens: Coping with challenging complexity

Autophagy: Nobel Prize 2016 and allergy and asthma research

Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment

Advances in the approach to the patient with food allergy

Mark S. La Shell, MD, Christopher W. Calabria, MD, James M. Quinn, MD

Prevention of food allergy: Beyond peanut

Risk of oral food challenges

Epinephrine absorption in children with a history of anaphylaxis

Phillip Lieberman, MD, Richard A

Benjamin Chaigne, MD, Hervé Watier, MD, PhD

Epinephrine (adrenaline) absorption from new-generation, taste-masked sublingual tablets: A preclinical study Ousama Rachid, BPharm, MSc, Mutasem M.

Reply Journal of Allergy and Clinical Immunology

Anaphylaxis Journal of Allergy and Clinical Immunology

Anaphylaxis, killer allergy: Long-term management in the community

9. Anaphylaxis Journal of Allergy and Clinical Immunology

Pınar Uysal, MD, Esben Eller, MSc, PhD, Charlotte G

Measles and immunomodulation

Managing asthma exacerbations in the emergency department: Summary of the National Asthma Education and Prevention Program Expert Panel Report 3 guidelines.

Macrolide antibiotics and asthma treatment

Asthma: The past, future, environment, and costs

Placental transfer of allergen-specific IgG but not IgE from a specific immunotherapy– treated mother Sabine Flicker, PhD, Katharina Marth, MD, Heinz.

Environmental factors and eosinophilic esophagitis

The GILL study: Glycerin-induced local reactions in immunotherapy

The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy Jennifer M. Maloney, MD, Magnus Rudengren, BSc, Staffan.

Advances in pediatric asthma in 2007

Natural history of cow’s milk allergy

Primary prevention of asthma and allergy

Presentation transcript:

Anaphylaxis during pregnancy F. Estelle R. Simons, MD, FRCPC, Michael Schatz, MD, MSc Journal of Allergy and Clinical Immunology Volume 130, Issue 3, Pages 597-606 (September 2012) DOI: 10.1016/j.jaci.2012.06.035 Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Potential symptoms and signs of anaphylaxis during pregnancy. Sudden onset of multisystem symptoms and signs is characteristic; most symptoms and signs are similar to those in nonpregnant patients with anaphylaxis. Itching in the vulvar/vaginal areas, low back pain, uterine cramps, fetal distress, and preterm labor can occur. Data are taken from references 1, 10, and 30. Journal of Allergy and Clinical Immunology 2012 130, 597-606DOI: (10.1016/j.jaci.2012.06.035) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Treatment of anaphylaxis during pregnancy. This involves prompt intramuscular injection of 0.3 mg (0.3 mL) of epinephrine using a 1 mg/mL (1:1000) dilution; high-flow supplemental oxygen; the mother positioned on her left side to improve venous return to the heart; maintenance of a minimum systolic blood pressure of 90 mm Hg for adequate placental perfusion; continuous electronic monitoring; cardiopulmonary resuscitation when indicated; and emergency cesarean delivery when indicated. Data are taken from references 1, 4, 10, 30, 47, 48, and 50. Journal of Allergy and Clinical Immunology 2012 130, 597-606DOI: (10.1016/j.jaci.2012.06.035) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Anaphylaxis during pregnancy: risk assessment and risk reduction. (1) Etiology suggested by history should be confirmed by measuring allergen-specific IgE levels in serum. (2) Strict avoidance of relevant confirmed allergen triggers is recommended. Initiation of allergen immunotherapy and desensitization to medications are usually deferred until after parturition because of the small associated risk of anaphylaxis. (3) Patients should be taught to self-inject epinephrine in the mid-outer thigh and equipped with a personalized anaphylaxis emergency action plan and medical identification. Data are taken from references 5, 10, 11, 14, and 57 to 65. Journal of Allergy and Clinical Immunology 2012 130, 597-606DOI: (10.1016/j.jaci.2012.06.035) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions