Table 2 Summary of cases with type I hypersensitivity-induced premature uterine contractions
From: Anaphylaxis-induced premature uterine contractions: a case report and literature review
Number | Authors/Year | Patient | Details of reaction | Presentation | Treatments | Response to treatment | Final outcome |
|---|---|---|---|---|---|---|---|
1. | Klein et al. 1984 [72] | 32 year-old, 29 weeks of gestation | Reaction following the ingestion of crab and cherries | Pruritus and urticaria, palmoplantar erythema, hypotension and uterine contractions. Fetal heart rate 138 bpm then 150 bpm with repetitive decelerations. | Diphenhydramine 50 mg, IV fluids, oxygen, ephedrine 5 mg IV ephedrine 10 mg IV | The contractions continued despite the treatment, the deceleration diminished gradually within 25 minutes with complete resolution after 2 hours. | Cesarean delivery at 40+5 weeks of gestation. The baby was normal. |
2 | Habek et al. 2000 [73] | 23 year-old 27 weeks of gestation | Reaction following by a wasp sting | Swollen face, eyelids, lip, tongue. Tachypnea, dyspnea, bronchospasm, uterine contractions | Adrenaline 0.5 mg for 3 doses, IV fluids, oxygen, Methylprednisolone 500 mg IV, Aminophylline 250 mg IV, 10% calcium gluconate 10 ml IV | Facial edema and uterine contractions subsided Normal cardiotocography examination | Delivery at 35 weeks of gestation |
3 | Donahue et al. 1995 [76] | 26 year-old 19 weeks of gestation | Telangiectasia macularis eruptiva perstans (rare type of mastocytosis) | Chest tightness, dyspnea, uterine contractions, vaginal bleeding and maculopapular rash | Chlorpheniramine, Terbutaline aerosols, Promethazine | Dysnea and uterine contractions relieved after treatment | Preterm labor at 24 weeks treated with magnesium sulfate. A normal baby was born by Caesarean delivery at 36 weeks |
4 | Kehoe et al. 2006 [77] | 35-year-old 24 weeks of gestation | Systematic mastocytosis Anxiety and stress | Uterine cramping, peptic ulcer disease, diarrhea,flushing, fatigue, and rash | H1 and H2 blocker, proton pump inhibitor, leukotriene inhibitors | Relieved uterine contractions and other symptoms | Spontaneous delivery at term gestation with 3,310g female infant |
5 | Madendag et al. 2010 [78] | 26-year-old 27 weeks of gestation | Cutaneous mastocytosis | Cutaneous manifestations with pruritus and premature uterine contractions | Pheniramine maleate 50 mg IV | Cutaneous manifestations and uterine contractions were resolved | Spontaneous vaginal delivery at 40 weeks of gestation |
6 | Romero et al. 2010 [18] | 28 year-old 31 weeks of gestation | Symptoms occurred shortly after ingestion of lobster | Generalized pruritic maculopapular rash, regular strong uterine contractions every three minutes | Chlorphenamine and betamethasone orally | Rash and uterine contractions subsided | Cesarean delivery at 40 weeks of gestation and delivered infant weighed 3800 g. The child developed atopic disorders. |
7 | Tsuzuki et al. 2017 [75] | 26 year-old 25 weeks of gestation | Symptoms occurred 15-30 min after meal | Bronchospasm with peripheral cyanosis, generalized itchy rash, abdominal pain and regular uterine contractions | Oxygen Epinephrine 0.4 mg intramuscula Nebulized short-acting β2-receptor agonist | Bronchospasm, rash and uterine contractions resolved | Delivery at 37 weeks of gestation. Skin prick test revealed buckwheat allergy. |