Anaphylaxis in labor secondary to prophylaxis against group B Streptococcus. A case report.
BACKGROUND
Two strategies have been recommended by the Centers for Disease Control and Prevention and approved by the American College of Obstetrics and Gynecology to help prevent group B streptococcal disease in the newborn. Both involve using penicillin in labor. However, the potential for allergic and even anaphylactic reactions to penicillin exists.


METHODS
A patient was treated for risk factors for group B Streptococcus in labor and suffered a serious anaphylactic reaction to penicillin; it resulted in an emergency cesarean section. Although the patient and infant were eventually discharged, the patient developed disseminated intravascular coagulation and suffered acute tubular necrosis that required dialysis.


CONCLUSIONS
Prophylaxis against group B streptococcal sepsis is of proven benefit, but the possible harm to the mother and fetus from treatment with penicillin must be recognized.
D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced* / Q000628:therapy; D002585:Cesarean Section; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced; D004630:Emergencies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications; D006801:Humans; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced; D007744:Obstetric Labor Complications / Q000188:drug therapy* / Q000209:etiology; D007752:Obstetric Labor, Premature / Q000150:complications; D010406:Penicillins / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000209:etiology; D013292:Streptococcus agalactiae