A Case Report of Anaphylactic Shock During Caesarean Section under Spinal Anesthesia

Authors
Atena sadat Hosseini 1
Zohreh Salari 2
Mostafa Khaleghipour 3
Reza Gharavian 4
Asghar Dalili 5
kiana Babaei 3
1 Department of Anesthesiology, Allied Medical Sciences Faculty, Kashan University of Medical Sciences, Kashan, Iran
2 Department of Gynecology, Neyshabur University of Medical Sciences, Neyshabur, Iran
3 Department of Anesthesia, Neyshabur University of Medical Sciences, Neyshabur, Iran
4 Department of Anesthesia, Hakim Hospital, Neyshabur University of Medical Sciences, Neyshabur, Iran
5 Department of Internal Medicine and Nephrology, Neyshabur University of Medical Sciences, Neyshabur, Iran
Abstract
Introduction

Anaphylaxis is an acute multi-organ dysfunction syndrome produced by the immunogenic release of inflammatory mediators from mast cells and basophils. This complication is typically a result of medications or substances used during surgery and can have fatal consequences.

Case

A 41-year-old woman underwent spinal anesthesia for cesarean section. After the delivery of the fetus and clamping of the umbilical cord, 5 units of oxytocin were injected intravenously and 25 units were

infused. All infusions were stopped when the patient complained of swollen lips, periorbital edema, and skin rashes. Subsequently, the patient experienced agitation, decreased SPO2, respiratory distress, and loss of peripheral pulses and was subjected to tracheal intubation. Subsequently, the patient developed ventricular tachycardia, and immediate cardiopulmonary resuscitation was initiated. The patient was cared for until the improvement of respiratory and hemodynamic status. After extubation, the patient was transferred to the intensive care unit and discharged after 24 days of treatment with improved condition.

Conclusion

Anaphylaxis is a life-threatening reaction in a pregnant mother, but its complications in the mother and neonate can be prevented through interdisciplinary cooperation, rapid diagnosis, and treatment.
Keywords
Anaphylactic Shock
Anaphylaxis
Spinal Anesthesia
Cesarean Section
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