{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:30:05Z","timestamp":1787589005816,"version":"build-2736575974"},"reference-count":77,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Anaphylactic reactions during pregnancy can range from subjective cutaneous symptoms to anaphylaxis and lethal anaphylactic shock. The fetal and maternal outcomes are unpredictable. This study is the first systematic review of the clinical presentation of severe anaphylaxis in pregnancy as defined by the World Allergy Organization to determine maternal and fetal outcomes. We searched PubMed, the Web of Science, and Scopus databases for articles published between 1 January 1985 and 15 April 2021 using the following terms (((anaphylactic shock) AND (pregnancy)) OR ((anaphylaxis) AND (pregnancy))). In 42 studies involving 47 patients, 36.17% of patients were 31\u201335 years old, and 74.47% of cases occurred peripartum, mostly during cesarean section. Accurate diagnosis with valid and reliable outcome measures was reported for 71.74% of cases. Twenty-two allergens were identified: antibiotics (penicillins and cephalosporins), anesthetic drugs (suxamethonium, mepivacaine), latex, oxytocin, sodium and sucrose iron, laminaria, misoprostol, rubber from Foley catheter, oral phytomenadione, ranitidine, chamomile, and ant sting. Two cases of maternal death related to latex and intravenous iron sucrose, and six infants with neurological disease were reported, mostly related to antibiotics. This review of the currently available literature shows that favorable outcomes are attainable with a high degree of observation, multidisciplinary cooperation, and rapid treatment.<\/jats:p>","DOI":"10.3390\/jpm11111060","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T09:18:09Z","timestamp":1634894289000},"page":"1060","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Severe Anaphylaxis in Pregnancy: A Systematic Review of Clinical Presentation to Determine Outcomes"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9334-0199","authenticated-orcid":false,"given":"Anca Angela","family":"Simionescu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Mihaela","family":"Danciu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Neonatology, National Institute for Maternal and Child Health \u201cAlfred Rusescu\u201d\u2014Polizu, 127715 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4807-9470","authenticated-orcid":false,"given":"Ana Maria Alexandra","family":"Stanescu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Carol Davila University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1111\/all.12437","article-title":"Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology","volume":"69","author":"Muraro","year":"2014","journal-title":"Allergy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e151","DOI":"10.1016\/j.bja.2018.12.009","article-title":"Anaphylaxis-related mortality in the obstetrical setting: Analysis of the French National Confidential Enquiry into Maternal Deaths from 2001 to 2012","volume":"123","author":"Tacquard","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1111\/1471-0528.15041","article-title":"The incidence, characteristics, management and outcomes of anaphylaxis in pregnancy: A population-based descriptive study","volume":"125","author":"McCall","year":"2018","journal-title":"BJOG"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1111\/anae.15069","article-title":"Anaphylaxis in pregnancy: A population-based multinational European study","volume":"75","author":"McCall","year":"2020","journal-title":"Anaesthesia"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1111\/all.12272","article-title":"The epidemiology of anaphylaxis in Europe: A systematic review","volume":"68","author":"Panesar","year":"2013","journal-title":"Allergy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1515\/JPM.2004.070","article-title":"Maternal anaphylaxis and fetal brain damage after intrapartum chemoprophylaxis","volume":"32","author":"Berardi","year":"2004","journal-title":"J. Perinat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/j.jaip.2020.10.047","article-title":"Beta-2 Agonists May be Superior to Epinephrine to Relieve Severe Anaphylactic Uterine Contractions","volume":"9","author":"Graham","year":"2021","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.annfar.2009.06.023","article-title":"Choc anaphylactique au cours de la grossesse \u00e0 terme. A propos de deux cas et revue de la litt\u00e9rature [Anaphylaxis in terminal pregnancy: Two case studies and review of the literature]","volume":"28","author":"Sleth","year":"2009","journal-title":"Ann. Fr. Anesth. Reanim."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1213\/ANE.0b013e3182a706c7","article-title":"Anaphylaxis in the clinical setting of obstetric anesthesia: A literature review","volume":"117","author":"Hepner","year":"2013","journal-title":"Anesth. Analg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.ijoa.2008.05.002","article-title":"Anaphylactic shock in pregnancy: A case study and review of the literature","volume":"17","author":"Chaudhuri","year":"2008","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1097\/00000542-200309000-00007","article-title":"Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999\u20132000","volume":"99","author":"Mertes","year":"2003","journal-title":"Anesthesiology"},{"key":"ref_12","first-page":"145","article-title":"Maternal Mortality in a Tertiary Care Hospital: Three Years Retrospective Study","volume":"18","author":"Jyotsana","year":"2016","journal-title":"JK Sci."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Carra, S., Schatz, M., Mertes, P.M., Torres, M.J., Fuchs, F., Senna, G., Castells, M.C., Demoly, P., and Tanno, L.K. (2021). Anaphylaxis and Pregnancy: A Systematic Review and Call for Public Health Actions. J. Allergy Clin. Immunol. Pract.","DOI":"10.1016\/j.jaip.2021.07.046"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Simionescu, A.A., Stanescu, A.M.A., and Popescu, F.-D. (2021). State-of-the-Art on Biomarkers for Anaphylaxis in Obstetrics. Life, 11.","DOI":"10.3390\/life11090870"},{"key":"ref_15","first-page":"39","article-title":"Progetto pilota sulla sorveglianza delle reazioni avverse a prodotti a base di piante officinali e integratori alimentari [Pilot study for the surveillance of adverse reactions to herbal preparations and dietary supplements]","volume":"41","author":"Mazzanti","year":"2005","journal-title":"Ann. Ist. Super Sanita."},{"key":"ref_16","first-page":"480","article-title":"Management of group B Streptococcus in pregnant women with penicillin allergy","volume":"52","author":"Philipson","year":"2007","journal-title":"J. Reprod. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4544","DOI":"10.1016\/j.vaccine.2011.04.055","article-title":"Active and passive surveillance of yellow fever vaccine 17D or 17DD-associated serious adverse events: Systematic review","volume":"29","author":"Thomas","year":"2011","journal-title":"Vaccine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/ajo.12794","article-title":"Intravenous iron use in pregnancy: Ironing out the issues and evidence","volume":"58","author":"Seeho","year":"2018","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"100472","DOI":"10.1016\/j.waojou.2020.100472","article-title":"World allergy organization anaphylaxis guidance 2020","volume":"13","author":"Cardona","year":"2020","journal-title":"World Allergy Organ. J."},{"key":"ref_20","unstructured":"(2021, September 06). Available online: https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=276244."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1136\/bmjebm-2017-110853","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"Murad","year":"2018","journal-title":"BMJ Evid. Based Med."},{"key":"ref_23","first-page":"491","article-title":"Anaphylaxis in pregnancy","volume":"71","author":"Gallagher","year":"1988","journal-title":"Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/S0750-7658(89)80119-4","article-title":"Choc anaphylactique perop\u00e9ratoire au latex [Peroperative anaphylactic shock caused by latex]","volume":"8","author":"Jorrot","year":"1989","journal-title":"Ann. Fr. Anesth. Reanim."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"381","DOI":"10.3109\/00016348909028678","article-title":"Severe complication to phytomenadione after intramuscular injection in woman in labor. Case report and review of literature","volume":"68","author":"Anderson","year":"1989","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/0140-6736(91)92574-L","article-title":"Anaphylactic reaction to ampicillin and severe complication in the fetus","volume":"337","author":"Heim","year":"1991","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/0091-6749(92)90389-J","article-title":"Latex hypersensitivity after natural delivery","volume":"89","author":"Laurent","year":"1992","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1177\/0310057X9302100539","article-title":"Anaphylactoid reaction to ranitidine in an obstetric patient","volume":"21","author":"Powell","year":"1993","journal-title":"Anaesth. Intensive Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1111\/j.1365-2044.1994.tb03501.x","article-title":"Anaphylaxis in pregnancy--the right treatment?","volume":"49","author":"Edmondson","year":"1994","journal-title":"Anaesthesia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1447-0756.1995.tb00915.x","article-title":"Anaphylactic reaction to cefazolin in pregnancy","volume":"21","author":"Konno","year":"1995","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/0959-289X(95)82443-E","article-title":"Latex anaphylaxis during late pregnancy","volume":"4","author":"Stewart","year":"1995","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.1471-0528.1996.tb09672.x","article-title":"Latex allergy as a risk during delivery","volume":"103","author":"Diaz","year":"1996","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/bja\/78.2.224","article-title":"Anaphylaxis associated with, but not caused by, extradural bupivacaine","volume":"78","author":"Rae","year":"1997","journal-title":"Br. J. Anaesth."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/S0020-7292(98)00129-5","article-title":"Placental abruption and intrauterine death following an ant sting","volume":"63","author":"Rizk","year":"1998","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/S0091-6749(98)70345-8","article-title":"Fatal outcome of anaphylaxis to camomile-containing enema during labor: A case study","volume":"102","author":"Reider","year":"1998","journal-title":"J Allergy Clin. Immunol."},{"key":"ref_36","first-page":"1025","article-title":"Anaphylaxis after laminaria insertion","volume":"95","author":"Cole","year":"2000","journal-title":"Obstet. Gynecol."},{"key":"ref_37","first-page":"539","article-title":"Maternal anaphylactic reaction to a general anaesthetic at emergency caesarean section for fetal bradycardia","volume":"108","author":"Stannard","year":"2001","journal-title":"BJOG"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1097\/00000542-200110000-00040","article-title":"Anaphylaxis due to airborne exposure to latex in a primigravida","volume":"95","author":"Eckhout","year":"2001","journal-title":"Anesthesiology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1159\/000067888","article-title":"Severe allergy in a pregnant woman after vaginal examination with a latex glove","volume":"54","author":"Shingai","year":"2002","journal-title":"Gynecol. Obstet. Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1034\/j.1398-9995.2001.1n3459.x","article-title":"Allergic anaphylaxis to Laminaria","volume":"57","author":"Knowles","year":"2002","journal-title":"Allergy"},{"key":"ref_41","first-page":"1332","article-title":"The use of a continuous infusion of epinephrine for anaphylactic shock during labor","volume":"102","author":"Gei","year":"2003","journal-title":"Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"886","DOI":"10.3346\/jkms.2003.18.6.886","article-title":"Two cases of anaphylaxis after laminaria insertion","volume":"18","author":"Kim","year":"2003","journal-title":"J. Korean Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.ijoa.2005.05.001","article-title":"Anaphylactoid reaction to intravenous sodium ferric gluconate complex during pregnancy","volume":"14","author":"Cuciti","year":"2005","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.resuscitation.2005.06.001","article-title":"Cardiac arrest and resuscitation with an automatic mechanical chest compression device (LUCAS) due to anaphylaxis of a woman receiving caesarean section because of pre-eclampsia","volume":"68","author":"Vatsgar","year":"2006","journal-title":"Resuscitation"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/j.forsciint.2008.03.021","article-title":"Anaphylactic latex reaction during anaesthesia: The silent culprit in a fatal case","volume":"179","author":"Turillazzi","year":"2008","journal-title":"Forensic. Sci. Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1080\/01443610802260595","article-title":"Anaphylactic reaction to ceftriaxone in labour. An emerging complication","volume":"28","author":"Khan","year":"2008","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.annfar.2008.10.007","article-title":"Choc anaphylactique au latex en cours de c\u00e9sarienne: \u00c0 propos de deux cas survenus en Guadeloupe [Latex induced anaphylactic shock during caesarean section: Two cases fro Guadeloupe]","volume":"27","author":"Delaunay","year":"2008","journal-title":"Ann. Fr. Anesth. Reanim."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ijoa.2008.09.004","article-title":"Pulseless electrical activity during caesarean delivery under spinal anaesthesia: A case report of severe anaphylactic reaction to Syntocinon","volume":"18","author":"Pant","year":"2009","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.annfar.2009.06.024","article-title":"Choc anaphylactique d\u00fb \u00e0 la succinylcholine compliqu\u00e9 de rhabdomyolyse [Anaphylactic shock from succinylcholine, complicated by a rhabdomyolysis]","volume":"28","author":"Rocchiccioli","year":"2009","journal-title":"Ann. Fr. Anesth. Reanim."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"374791","DOI":"10.1155\/2009\/374791","article-title":"Severe Anaphylaxis to Volplex, a Colloid Solution during Cesarean Section: A Case Report and Review","volume":"2009","author":"Karri","year":"2009","journal-title":"Obstet. Gynecol. Int."},{"key":"ref_51","first-page":"98","article-title":"A Pregnant Developed Cardiac Arrest Due to Anaphylaxis","volume":"7","author":"Tekin","year":"2010","journal-title":"Eur. J. Gen. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"93","DOI":"10.4103\/0253-7613.106446","article-title":"Fatal anaphylactic reaction to iron sucrose in pregnancy","volume":"45","author":"Mishra","year":"2013","journal-title":"Indian J. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.anai.2013.03.014","article-title":"Oxytocin: A likely underestimated risk for anaphylactic reactions in delivering women sensitized to latex","volume":"110","author":"Liccardi","year":"2013","journal-title":"Ann. Allergy Asthma. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.ejogrb.2014.09.012","article-title":"Anaphylactic shock after misoprostol in voluntary termination of pregnancy\u2014A case report","volume":"182","author":"Alarcon","year":"2014","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/AOG.0000000000000268","article-title":"Anaphylaxis to buccal misoprostol for labor induction","volume":"124","author":"Schoen","year":"2014","journal-title":"Obstet. Gynecol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.ijoa.2014.12.009","article-title":"Anaphylaxis-induced hyperfibrinolysis in pregnancy","volume":"24","author":"Truong","year":"2015","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1007\/s00540-016-2280-4","article-title":"A suspected case of rocuronium-sugammadex complex-induced anaphylactic shock after cesarean section","volume":"31","author":"Yamaoka","year":"2017","journal-title":"J. Anesth."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e12351","DOI":"10.1097\/MD.0000000000012351","article-title":"Maternal anaphylactic shock in pregnancy: A case report","volume":"97","author":"Jeon","year":"2018","journal-title":"Medicine"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"433","DOI":"10.18176\/jiaci.0311","article-title":"Doxylamine Allergy in a Pregnant Woman: Suitability of the Basophil Activation Test","volume":"28","author":"Rial","year":"2018","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s40981-019-0302-6","article-title":"Mepivacaine-induced anaphylactic shock in a pregnant woman undergoing combined spinal and epidural anesthesia for cesarean delivery: A case report","volume":"5","author":"Takahashi","year":"2019","journal-title":"JA Clin. Rep."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"163.e1","DOI":"10.1016\/j.ajem.2019.158409","article-title":"Intubation and intensive care after laminaria anaphylaxis in second-trimester abortion","volume":"38","author":"McQuade","year":"2020","journal-title":"Am. J. Emerg. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1177\/1753495X16689444","article-title":"Indirect maternal deaths: UK and global perspectives","volume":"10","author":"Nair","year":"2017","journal-title":"Obstet. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.anai.2009.11.005","article-title":"Anaphylaxis in the obstetric patient: Analysis of a statewide hospital discharge database","volume":"104","author":"Mulla","year":"2010","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1111\/bjh.16221","article-title":"UK guidelines on the management of iron deficiency in pregnancy","volume":"188","author":"Pavord","year":"2020","journal-title":"Br. J. Haematol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ijoa.2006.08.006","article-title":"Anaphylactic reactions during cesarean section","volume":"16","author":"Draisci","year":"2007","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1111\/1471-0528.15995","article-title":"Royal College of Obstetricians and Gynaecologists. Maternal Collapse in Pregnancy and the Puerperium: Green-top Guideline No. 56","volume":"127","author":"Chu","year":"2020","journal-title":"BJOG"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/j.1399-6576.2006.00962.x","article-title":"Cardiopulmonary distress during obstetrical anaesthesia: Attempts to diagnose amniotic fluid embolism in a case series of suspected allergic anaphylaxis","volume":"50","author":"Harboe","year":"2006","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.amjms.2016.05.030","article-title":"Allergy Medications During Pregnancy","volume":"352","author":"Geraci","year":"2016","journal-title":"Am. J. Med. Sci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1172\/JCI114051","article-title":"Time course of appearance and disappearance of human mast cell tryptase in the circulation after anaphylaxis","volume":"83","author":"Schwartz","year":"1989","journal-title":"J. Clin. Investig."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/j.1399-6576.2007.01489.x","article-title":"Systematic follow-up increases incidence of anaphylaxis during adverse reactions in anesthetized patients","volume":"52","author":"Malinovsky","year":"2008","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/WOX.0b013e318211496c","article-title":"World allergy organization guidelines for the assessment and management of anaphylaxis","volume":"4","author":"Simons","year":"2011","journal-title":"World Allergy Organ. J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1056\/NEJM199208063270603","article-title":"Fatal and near-fatal anaphylactic reactions to food in children and adolescents","volume":"327","author":"Sampson","year":"1992","journal-title":"N Engl. J. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1046\/j.1365-2222.2000.00864.x","article-title":"Lessons for management of anaphylaxis from a study of fatal reactions","volume":"30","author":"Pumphrey","year":"2000","journal-title":"Clin. Exp. Allergy"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1097\/00000542-200212000-00034","article-title":"Fetal and Maternal Effects of Phenylephrine and Ephedrine during Spinal Anesthesia for Cesarean Delivery","volume":"97","author":"Cooper","year":"2002","journal-title":"Anesthesiology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.ajem.2004.07.016","article-title":"Appropriate use of epinephrine in anaphylaxis","volume":"22","author":"Anchor","year":"2004","journal-title":"Am. J. Emerg. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/0002-9378(71)90873-8","article-title":"Production of fetal asphyxia in the rhesus monkey by administration of catecholamines to the mother","volume":"109","author":"Adamsons","year":"1971","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/00007611-198403000-00038","article-title":"Anaphylaxis in pregnancy","volume":"77","author":"Entman","year":"1984","journal-title":"South. Med. J."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/11\/1060\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:20:50Z","timestamp":1760167250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/11\/11\/1060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,22]]},"references-count":77,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["jpm11111060"],"URL":"https:\/\/doi.org\/10.3390\/jpm11111060","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,22]]}}}