This multidisciplinary review examines anaphylaxis during pregnancy — covering epidemiology, triggers, pathophysiology, diagnosis, management, and prevention — with input from allergy-immunology, obstetrics, anesthesiology, and epidemiology experts.
Prompt intramuscular epinephrine is identified as safe and critical first-line therapy; delayed intervention is associated with worse maternal and fetal outcomes. Gestational cardiovascular and respiratory changes can mask classic anaphylaxis signs, contributing to diagnostic variability and avoidable adverse events.
Narrative/expert review design without systematic search or meta-analysis; anaphylaxis in pregnancy is rare, limiting the size and quality of the underlying evidence base; no original patient-level data are presented.
Do not withhold epinephrine in a pregnant patient with anaphylaxis — the risk of untreated anaphylaxis to mother and fetus outweighs any theoretical concern about the drug. Coordinate care through structured interdisciplinary pathways involving obstetrics and allergy teams, especially for high-risk patients during labor and delivery.
