Recurrent Anaphylactoid Reaction During Caesarean Section

A 28-year-old woman in her fourth pregnancy had the following history. Her first pregnancy resulted in a salpingectomy under uneventful anesthesia because of a ruptured ectopic. The second pregnancy ended in emergency cesarean section at 30 weeks due to abruptio placentae. After delivery of the baby, she developed bronchospasm, cyanosis, tachycardia and edema of the face and upper airway which responded to general measures with the exception that artificial ventilation was needed for some time. The third pregnancy required hysterotomy at 23 weeks because of liver and renal compromiseshe developed a similar allergic reaction after evacuation of the uterus. Subsequent skin testing with the anesthetic agents used proved negative, but it was noted that she was atopic, suffering from hay fever and developing facial edema when eating eggs.