oxytocin and Drug-Hypersensitivity

Observation of an allergic peranaesthetic accident which occurred twice in the same patient for two successive cesarean sections. Because we could not avoid the renewal of this dangerous situation, we try to criticize our own attitude. This case is compared with others which have been published previously to attempt a strategy in order to prevent this woman from a third hypersensitivity reaction.

Topics: Adult; Anesthesia, Obstetrical; Anesthetics; Cesarean Section; Drug Hypersensitivity; Female; Humans; Intraoperative Complications; Oxytocin; Pregnancy; Recurrence; Skin Tests

In Denmark, an iv bolus of 10 IU oxytocin was traditionally given after delivery to prevent atony during caesarean sections. Randomized controlled trials have shown that lower iv bolus doses have same efficacy with fewer side effects and many countries now recommend a 5 IU maximum dose. The aims of this study were to investigate whether patients referred for allergy testing after oxytocin exposure had dose-related side effects to oxytocin rather than true allergic reactions and to investigate whether updated international recommendations on lower bolus doses had been implemented in practice.. Medical notes of patients tested with oxytocin as part of investigations in the Danish Anaesthesia Allergy Centre from May 2004 to January 2014 were reviewed retrospectively. A telephone survey of on-duty obstetricians at all Danish obstetric departments was performed and most recent online recommendations from the Danish societies of obstetrics and anaesthesia about the use of oxytocin were identified.. In total 30 women were tested with oxytocin as part of investigations. None were allergic to oxytocin but 19 had symptoms consistent with dose-related side effects on iv provocation. The telephone survey revealed that iv doses of 10 IU oxytocin were still used and recommendations on the websites were not updated.. Too high oxytocin doses are still used in Denmark leading to dose-related side effects mimicking allergic reactions. Coordination between obstetricians and anaesthesiologists on producing common updated guidelines on the administration of oxytocin and dissemination of this information to obstetric and anaesthetic departments in Denmark is needed.

Topics: Adult; Cesarean Section; Cohort Studies; Denmark; Dose-Response Relationship, Drug; Drug Hypersensitivity; Female; Health Care Surveys; Humans; Oxytocics; Oxytocin; Pregnancy; Retrospective Studies; Telephone; Tryptases; Young Adult

Topics: Drug Hypersensitivity; Humans; Latex; Latex Hypersensitivity; Oxytocics; Oxytocin; Perioperative Care; Skin Tests

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

Topics: Aerosols; Blood Pressure; Breast; Costs and Cost Analysis; Diabetes Insipidus; Diuresis; Drug Combinations; Drug Hypersensitivity; Female; Humans; Intestines; Nose; Oxytocin; Tannins; Uterus; Vasopressins; Water Intoxication

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: Anesthesia, Obstetrical; Breast Feeding; Colic; Colostrum; Drug Hypersensitivity; Female; Food Hypersensitivity; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Lactation; Lactation Disorders; Massage; Milk, Human; Mother-Child Relations; Oxytocin; Physician-Patient Relations; Pregnancy; Prolactin

Topics: Adult; Drug Hypersensitivity; Female; Gestational Age; Humans; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Tests; Time Factors; Uterus

Topics: Biomedical Research; Clinical Laboratory Techniques; Drug Hypersensitivity; Female; Humans; Oxytocin; Pharmacology; Placebos; Pregnancy; Pregnancy Complications; Toxicology; Uterus