Department of Anaesthesia, Antwerp University Hospital, Antwerp, Belgium.
Int J Obstet Anesth. 2013 Jul;22(3):231-42. doi: 10.1016/j.ijoa.2013.04.010. Epub 2013 May 25.
Allergic reactions in the parturient are challenging for the anaesthetist who is dealing with both mother and baby, often in circumstances when there is a need for delivery. While most previous reviews have focused on specific substances in individual cases, this review focuses on allergic reactions during the peripartum period, the differential diagnosis and specific treatment options. Immunoregulation and susceptibility to allergic reactions may change during pregnancy. Compared with non-pregnant patients, in whom neuromuscular blocking drugs are the most common triggering substances, allergic reactions in parturients mostly occur following contact with latex, injection of antibiotics and uterotonics, and infusion of colloids. With the exception of latex, where patient history may raise suspicion, allergic reactions may occur without prior exposure to triggering agents. Most drugs used for resuscitation of the non-pregnant patient are suitable for the parturient. Some substances, such as H2-receptor antagonists for aspiration prophylaxis or corticosteroids for prematurity, may have been given before the event. Although fetal outcome is important, the mother is the primary focus of care.
产妇的过敏反应对麻醉师来说是一个挑战，因为他们需要同时处理母亲和婴儿的情况，而且通常需要进行分娩。虽然之前的大多数综述都集中在个别病例中的特定物质上，但本次综述重点关注围产期的过敏反应、鉴别诊断和特定的治疗选择。免疫调节和过敏反应的易感性可能会在怀孕期间发生变化。与非孕妇患者相比，在非孕妇患者中，神经肌肉阻滞剂是最常见的触发物质，而产妇的过敏反应主要发生在接触乳胶、注射抗生素和子宫收缩药以及输注胶体之后。除了乳胶，其病史可能会引起怀疑之外，过敏反应可能在没有接触到触发物质的情况下发生。大多数用于非孕妇复苏的药物都适用于产妇。一些物质，如用于预防吸入的 H2 受体拮抗剂或用于预防早产的皮质类固醇，可能在事件发生之前已经使用。尽管胎儿结局很重要，但母亲是护理的主要焦点。
