oxytocin and Anaphylaxis

Topics: Anaphylaxis; Female; Humans; Labor, Induced; Labor, Obstetric; Oxytocics; Oxytocin; Pregnancy

Topics: Adult; Anaphylaxis; Cross Reactions; Delivery, Obstetric; Female; Humans; Latex; Latex Hypersensitivity; Oxytocin

Anaphylactoid reaction to Syntocinon is rare, but has been described in the literature. The reactions described include patchy erythema, hypotension, bronchospasm and oxygen desaturation, but pulseless electrical activity following Syntocinon has not been reported. We present the case of a 34-year-old primigravida with essential hypertension, gestational diabetes and hypothyroidism with a twin pregnancy following in vitro fertilization. During elective caesarean delivery she developed a severe anaphylactic reaction to Syntocinon leading to pulseless electrical activity.

Topics: Adult; Anaphylaxis; Anesthesia, Spinal; Electrocardiography; Female; Humans; Hypertension; Hypothyroidism; Oxytocics; Oxytocin; Palpation; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Twins

Topics: Adult; Allergens; Amino Acid Sequence; Anaphylaxis; Antigens, Plant; Cesarean Section; Female; Humans; Intraoperative Complications; Latex Hypersensitivity; Molecular Sequence Data; Oxytocics; Oxytocin; Plant Proteins; Pregnancy; Sequence Homology

"Piton-S", a preparation of synthetic hormone of oxytocin, is the most common pharmacologic agent used for the induction and augmentation of labor, as well as preventing postpartum hemorrhage owing to its uterotonic properties. There are many adverse effects reported with oxytocin, including hypotension and tachycardia. Anaphylactoid reaction to oxytocin is extremely rare. Here we bring forth a case who sustained from anaphylactoid shock following oxytocin administration during the act of cesarean section. We would like to discuss the proper management of perioperative anaphylaxis after review of similar cases in the literature.

Topics: Adult; Anaphylaxis; Female; Humans; Oxytocin; Pregnancy

We report a case of intraoperative anaphylactic shock in a 32-year-old multigravida woman undergoing elective cesarean section for partial placenta previa. Anesthesia was performed using combined spinal and epidural technique. After the baby was born, methylergometrine was administered i.v. simultaneously with oxytocin, the latter injected directly into the uterine muscle by an obstetrician. Several minutes later, she presented with dyspnea and became agitated. Because of the potential risk of pulmonary embolism, the patient was immediately intubated and mechanical ventilation was started. Her systolic blood pressure decreased to 50 mmHg and SpO2 to 87% under 100% oxygen administration. After catecholamine infusion, however, her respiratory condition soon improved. Postoperatively, her conjunctiva and vulva were not edematous. From the clinical course, it was considered that the patient was very likely to have suffered an anaphylactic reaction to oxytocin or methylergometrine. Forty days later, serological examinations as well as skin tests for those two drugs were carried out. While the serological tests were negative, the skin tests indicated the patient was allergic to both drugs. It is concluded that the endogenous peptide oxytocin can induce anaphylactic shock in multiparous women.

Topics: Adult; Anaphylaxis; Anesthesia, Obstetrical; Cesarean Section; Female; Humans; Intraoperative Complications; Methylergonovine; Oxytocics; Oxytocin; Placenta Previa; Pregnancy; Skin Tests

Topics: Abortion, Induced; Adult; Anaphylaxis; Bronchial Spasm; Critical Care; Female; Humans; Laryngeal Diseases; Oxytocin; Pregnancy; Shock, Septic

We analyzed the clinical course and investigated possible pathophysiologic mechanisms of amniotic fluid embolism.. We carried out a retrospective review of medical records. Forty-six charts were analyzed for 121 separate clinical variables.. Amniotic fluid embolism occurred during labor in 70% of the women, after vaginal delivery in 11%, and during cesarean section after delivery of the infant in 19%. No correlation was seen with prolonged labor or oxytocin use. A significant relation was seen between amniotic fluid embolism and male fetal sex. Forty-one percent of patients gave a history of allergy or atopy. Maternal mortality was 61%, with neurologically intact survival seen in 15% of women. Of fetuses in utero at the time of the event, only 39% survived. Clinical and hemodynamic manifestations were similar to those manifest in anaphylaxis and septic shock.. Intact maternal or fetal survival with amniotic fluid embolism is rare. The striking similarities between clinical and hemodynamic findings in amniotic fluid embolism and both anaphylaxis and septic shock suggest a common pathophysiologic mechanism for all these conditions. Thus the term amniotic fluid embolism appears to be a misnomer.

Topics: Adolescent; Adult; Anaphylaxis; Chi-Square Distribution; Embolism, Amniotic Fluid; Female; Fetal Death; Fetus; Heart Rate, Fetal; Humans; Hypersensitivity; Male; Obstetric Labor Complications; Oxytocin; Pregnancy; Prognosis; Puerperal Disorders; Registries; Retrospective Studies; Sex Factors; Shock, Septic; Survival Rate; United States

Topics: Anaphylaxis; Humans; Intraoperative Complications; Latex; Oxytocin

A case of life-threatening respiratory distress during a Caesarean section under spinal anaesthesia is reported. Possible causes of the event including anaphylactoid reactions and the methods of their diagnosis are discussed. The most likely cause of the episode was felt to be an anaphylactoid reaction to Syntocinon.

Topics: Acute Disease; Adult; Anaphylaxis; Anesthesia, Obstetrical; Anesthesia, Spinal; Cesarean Section; Female; Humans; Intraoperative Complications; Oxytocin; Pregnancy; Respiratory Insufficiency

The plasma concentrations of arginine vasopressin, oxytocin, angiotensin I and II were studied in patients with hymenoptera venom anaphylaxis (n = 50) and healthy volunteers (n = 25). There was no difference in arginine vasopressin: 5.52 +/- 0.45 fmol/ml vs. 3.99 +/- 0.41 fmol/ml or oxytocin: 28.10 +/- 1.13 fmol/ml vs. 26.24 +/- 1.80 fmol/ml between patients and controls. No correlation between the severity of clinical symptoms and the plasma levels of arginine vasopressin and oxytocin was found in patients. However, patients with a history of hymenoptera venom anaphylaxis showed significantly reduced angiotensin I and angiotensin II plasma levels as compared to controls (ANG I: 9.51 +/- 0.61 fmol/ml vs. 22.91 +/- 1.73 fmol/ml; ANG II: 2.84 +/- 0.16 fmol/ml vs. 6.95 +/- 0.33 fmol/ml). A significant inverse correlation between the severity of clinical symptoms and the plasma levels of angiotensin I and angiotensin II was observed; the lower the concentrations the more severe the clinical symptoms. Oxytocin immunoreactivity eluted from the HPLC column as a single peak with the same retention time as synthetic oxytocin. The vasopressin immunoreactive material could be characterized on HPLC as arginine-vasopressin and two other peptides of unknown nature which crossreacted with the vasopressin antibody. These findings suggest a possible role of angiotensin I and angiotensin II in hymenoptera venom anaphylaxis while arginine vasopressin and oxytocin are most likely not involved.

Topics: Adolescent; Adult; Aged; Anaphylaxis; Angiotensin I; Angiotensin II; Angiotensins; Animals; Arginine Vasopressin; Arthropod Venoms; Child; Chromatography, High Pressure Liquid; Female; Humans; Hymenoptera; Male; Middle Aged; Oxytocin; Radioimmunoassay

Topics: Adult; Anaphylaxis; Anesthesia, Obstetrical; Angioedema; Cesarean Section; Chlorobutanol; Female; Humans; Hypotension; Oxytocin; Pregnancy

Human urine samples, purified on octadecasilyl-silica cartridges, contained immunoreactive angiotensin I, II, arginine vasopressin and oxytocin. The daily excretion of these peptides in healthy volunteers was 190.00 +/- 38.43 (n = 12), 17.48 +/- 3.09 (n = 12), 63.43 +/- 14.84 (n = 8) and 13.52 +/- 1.42 (n = 7) pmol/24 hr, respectively (mean +/- s.e.m.). Patients with a history of anaphylactoid reactions to drugs or food additives showed clinical symptoms such as urticaria, flush, nausea, dizziness and hypotension after oral provocation with cyanocobalamine, propyphenazone, acetylsalicylic acid and sodium benzoate. In five of the seven patients, angiotensin I and II were increased several fold in the urine fractions after symptoms were reported. The average increase in the urine concentration of both peptides was fourfold and 5.5-fold. In three out of five patients, the mean excretion of arginine vasopressin and oxytocin immunoreactive material was also elevated by a factor of 5.7 and 4.4, respectively. Oral provocation with a placebo failed to elicit anaphylactoid symptoms or an increase in the urine levels of angiotensin I or angiotensin II. Angiotensin I and angiotensin II-like immunoreactivity could be characterized on HPLC as Ile5-angiotensin I, Ile5-angiotensin II and angiotensin II metabolites. HPLC characterization of immunoreactive arginine vasopressin and oxytocin in two different gradient systems showed retention times different than the retention times of the corresponding synthetic standard peptides indicating that both peptides are not authentic AVP and OXT. These results suggest that angiotensin I and angiotensin II may be involved in the clinical events observed during some forms of anaphylactoid reactions.

Topics: Adult; Anaphylaxis; Angiotensin I; Angiotensin II; Antipyrine; Arginine Vasopressin; Aspirin; Benzoates; Benzoic Acid; Female; Humans; Male; Middle Aged; Oxytocin; Vitamin B 12

Topics: Adult; Anaphylaxis; Cesarean Section; Female; Humans; Intraoperative Complications; Oxytocin; Pregnancy; Recurrence

A case of an allergic reaction to synthetic oxytocin administered during cesarean section is reported. Epinephrine was more effective in improving the severe hypotension than ephedrine. The incidence of anaphylactoid reaction to oxytocin is very low, but this potential problem must always be kept in mind in daily obstetric practice.

Topics: Adult; Anaphylaxis; Cesarean Section; Epinephrine; Female; Humans; Hypotension; Oxytocin; Pregnancy

Topics: Abortion, Induced; Adult; Anaphylaxis; Chlorobutanol; Female; Humans; Intradermal Tests; Oxytocin; Pharmaceutic Aids; Pregnancy; Preservatives, Pharmaceutical

A case of an allergic reaction to Syntocinon (synthetic oxytocin) administered during Caesarean section is reported.

Topics: Adult; Anaphylaxis; Anesthesia, Obstetrical; Cesarean Section; Drug Hypersensitivity; Female; Humans; Intraoperative Complications; Oxytocin; Pregnancy; Pregnancy Complications

Within the last few years intra-amniotic (i.a.) instillation of prostaglandin F2 alpha (PGF2 alpha) has become the predominant method of second-trimester abortion in Denmark. The method is employed by nearly all the gynecological departments, where approximately 500 such procedures are carried out annually. Our own investigations have demonstrated that it is necessary to be somewhat restrictive in the administration of supplementary intravenous infusion of oxytocin. It is pointed out, illustrated by four case histories, that there is a potential risk of greater or smaller quantities of i.a. PGF2 alpha accidentally passing during the procedure to the circulation of the patient. This may result in circulatory collapse, among other things, possibly as a result of acute pulmonary hypertension. A number of safety measures are suggested to minimize this risk and to ensure effective treatment should such complications occur.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Adult; Amnion; Anaphylaxis; Carboprost; Cardiovascular Diseases; Denmark; Dinoprost; Drug Evaluation; Female; Humans; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Prostaglandins F; Saline Solution, Hypertonic

Topics: Allergens; Anaphylaxis; Animals; Antigen-Antibody Reactions; Child, Preschool; Diabetes Insipidus; Drug Hypersensitivity; Erythrocytes; Hemagglutination Tests; Histiocytosis, Langerhans-Cell; Humans; Immune Sera; Immunization, Passive; Immunochemistry; Immunodiffusion; Immunoglobulin E; Lysine; Male; Oxytocin; Phenylalanine; Sheep; Skin Tests; Vasopressins

Topics: Adrenocorticotropic Hormone; Amino Acids; Anaphylaxis; Antibodies; Chemical Phenomena; Chemistry; Humans; Melanocyte-Stimulating Hormones; Metabolism; Oxytocin; Peptides; Research; Ribonucleases