Anaphylaxis and Epinephrine Use in Pregnancy

Area of Science:

• Obstetrics and Gynecology
• Allergy and Immunology
• Epidemiology

Background:

• Anaphylaxis during pregnancy presents unique diagnostic and management challenges due to physiological changes.
• Pregnancy-specific factors can complicate anaphylaxis recognition, treatment, and prevention, leading to adverse outcomes.

Purpose of the Study:

• To provide a multidisciplinary review of anaphylaxis in pregnancy, covering epidemiology, pathophysiology, diagnosis, management, and outcomes.
• To synthesize evidence and offer a practical framework for health professionals to optimize care and maternal-fetal safety.

Main Methods:

• Multidisciplinary review of current evidence by experts in allergy-immunology, obstetrics, anesthesiology, and epidemiology.
• Synthesis of data on anaphylaxis triggers, diagnostic challenges, management protocols, and maternal/fetal outcomes.

Main Results:

• Gestational changes can mask classic anaphylaxis symptoms, complicating diagnosis.
• Intramuscular epinephrine is safe and essential as first-line treatment for anaphylaxis in pregnancy.
• Timely intervention significantly improves maternal and fetal outcomes compared to delayed treatment.

Conclusions:

• Increased awareness and structured interdisciplinary collaboration are vital for managing anaphylaxis in pregnancy.
• Integrating prevention strategies into obstetric and allergy care is crucial for reducing adverse events.
• Evidence-based guidelines are needed to support health professionals in optimizing diagnosis, management, and safety.