Anaphylaxis Following Cefazolin Administration in Pregnancy Managed With Delayed Cesarean Delivery: A Case Report

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Anaphylaxis during pregnancy is rare but potentially fatal. Limited evidence is available to guide decisions regarding delivery timing during maternal anaphylaxis. A 26‐year‐old woman at 38.5 weeks scheduled for elective cesarean delivery developed anaphylaxis immediately after prophylactic cefazolin infusion, presenting with hypotension, tachycardia, dyspnea, erythema, and facial edema. She was treated promptly with intramuscular and intravenous adrenaline, fluids, corticosteroids, oxygen, and left uterine displacement, achieving hemodynamic stabilization without biphasic reaction. Continuous fetal monitoring was reassuring, allowing cesarean section to be postponed. At 23 h, spontaneous labor commenced, and delivery was performed safely under spinal anesthesia following negative allergy testing. A healthy neonate was delivered, and both mother and infant recovered uneventfully. Anaphylaxis following cefazolin administration during pregnancy is extremely uncommon. This case suggests that, when fetal status remains reassuring, cesarean delivery may be postponed until maternal stabilization in selected patients.