Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report
Abstract Background Anaphylactic shock during pregnancy is a rare but life-threatening event for both the mother and the newborn. Case presentation A 42-year-old woman, who was pregnant with twins, was scheduled for cesarean delivery under combined spinal and epidural anesthesia. An epidural cathete...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2019-12-01
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| Series: | JA Clinical Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40981-019-0302-6 |
| _version_ | 1819182928745201664 |
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| author | Miyuki Takahashi Kunihisa Hotta Soichiro Inoue Tomonori Takazawa Tatsuo Horiuchi Takashi Igarashi Mamoru Takeuchi |
| author_facet | Miyuki Takahashi Kunihisa Hotta Soichiro Inoue Tomonori Takazawa Tatsuo Horiuchi Takashi Igarashi Mamoru Takeuchi |
| author_sort | Miyuki Takahashi |
| collection | DOAJ |
| description | Abstract Background Anaphylactic shock during pregnancy is a rare but life-threatening event for both the mother and the newborn. Case presentation A 42-year-old woman, who was pregnant with twins, was scheduled for cesarean delivery under combined spinal and epidural anesthesia. An epidural catheter was placed uneventfully. After spinal anesthesia, the patient exhibited skin symptoms and severe hypotension. The patient was diagnosed with anaphylaxis, and subsequently, treatment was started. Fetal heart rate monitoring revealed sustained bradycardia, and it was decided to proceed with cesarean delivery. After delivery, the mother’s vital signs recovered. Both infants were intubated due to birth asphyxia. Currently, the twins are 4 years old and exhibit no developmental problems. Clinical examination identified mepivacaine as the causative agent of anaphylaxis. Conclusions This case report highlights that upon occurrence of anaphylaxis during pregnancy, maternal treatment and fetal assessment should be started immediately. Indication for immediate cesarean delivery should be considered and a definite identification of the causative factor pursued. |
| first_indexed | 2024-12-22T22:53:55Z |
| format | Article |
| id | doaj.art-b243649cca9b4fb397663fe056246b29 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-22T22:53:55Z |
| publishDate | 2019-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-b243649cca9b4fb397663fe056246b292022-12-21T18:09:53ZengSpringerOpenJA Clinical Reports2363-90242019-12-01511410.1186/s40981-019-0302-6Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case reportMiyuki Takahashi0Kunihisa Hotta1Soichiro Inoue2Tomonori Takazawa3Tatsuo Horiuchi4Takashi Igarashi5Mamoru Takeuchi6Department of Anesthesiology and Critical Care Medicine, Jichi Medical UniversityDepartment of Anesthesiology and Critical Care Medicine, Jichi Medical UniversityDepartment of Anesthesiology, St. Marianna University School of MedicineIntensive Care Unit, Gunma University HospitalDepartment of Anesthesiology, Gunma University Graduate School of MedicineDepartment of Anesthesiology and Critical Care Medicine, Jichi Medical UniversityDepartment of Anesthesiology and Critical Care Medicine, Jichi Medical UniversityAbstract Background Anaphylactic shock during pregnancy is a rare but life-threatening event for both the mother and the newborn. Case presentation A 42-year-old woman, who was pregnant with twins, was scheduled for cesarean delivery under combined spinal and epidural anesthesia. An epidural catheter was placed uneventfully. After spinal anesthesia, the patient exhibited skin symptoms and severe hypotension. The patient was diagnosed with anaphylaxis, and subsequently, treatment was started. Fetal heart rate monitoring revealed sustained bradycardia, and it was decided to proceed with cesarean delivery. After delivery, the mother’s vital signs recovered. Both infants were intubated due to birth asphyxia. Currently, the twins are 4 years old and exhibit no developmental problems. Clinical examination identified mepivacaine as the causative agent of anaphylaxis. Conclusions This case report highlights that upon occurrence of anaphylaxis during pregnancy, maternal treatment and fetal assessment should be started immediately. Indication for immediate cesarean delivery should be considered and a definite identification of the causative factor pursued.https://doi.org/10.1186/s40981-019-0302-6AnaphylaxisPregnancyCesarean deliverySpinal anesthesiaLocal anestheticMepivacaine |
| spellingShingle | Miyuki Takahashi Kunihisa Hotta Soichiro Inoue Tomonori Takazawa Tatsuo Horiuchi Takashi Igarashi Mamoru Takeuchi Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report JA Clinical Reports Anaphylaxis Pregnancy Cesarean delivery Spinal anesthesia Local anesthetic Mepivacaine |
| title | Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report |
| title_full | Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report |
| title_fullStr | Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report |
| title_full_unstemmed | Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report |
| title_short | Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: a case report |
| title_sort | mepivacaine induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery a case report |
| topic | Anaphylaxis Pregnancy Cesarean delivery Spinal anesthesia Local anesthetic Mepivacaine |
| url | https://doi.org/10.1186/s40981-019-0302-6 |
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