Anaphylaxis Following Cefazolin Administration in Pregnancy Managed With Delayed Cesarean Delivery: A Case Report

Area of Science:

• Obstetrics and Gynecology
• Allergy and Immunology
• Anesthesiology

Background:

• Anaphylaxis in pregnancy is a rare but life-threatening condition.
• Limited evidence exists on optimal delivery timing during maternal anaphylaxis.
• Cefazolin-induced anaphylaxis in pregnancy is exceptionally uncommon.

Purpose of the Study:

• To report a case of anaphylaxis during pregnancy following cefazolin administration.
• To discuss the management of maternal anaphylaxis and its impact on delivery timing.
• To highlight the importance of fetal well-being in decision-making.

Main Methods:

• A case report of a 26-year-old pregnant woman at 38.5 weeks gestation experiencing anaphylaxis post-cefazolin.
• Management included adrenaline, fluids, corticosteroids, oxygen, and left uterine displacement.
• Continuous fetal monitoring was employed to assess fetal status.
• Cesarean delivery was postponed, and spontaneous labor was allowed.

Main Results:

• The patient achieved hemodynamic stabilization without biphasic reaction.
• Continuous fetal monitoring showed reassuring results, permitting postponement of cesarean delivery.
• Spontaneous labor initiated 23 hours later, and delivery proceeded safely under spinal anesthesia.
• Both mother and neonate recovered uneventfully.

Conclusions:

• Maternal anaphylaxis during pregnancy requires prompt and aggressive management.
• When fetal status is reassuring, cesarean delivery may be safely postponed until maternal stabilization.
• This case underscores the possibility of delaying delivery in select anaphylaxis cases during pregnancy.