Hypersensitivity reactions following laminaria placement.
Laminaria tents are commonly placed intracervically prior to elective termination of pregnancy. Three women, each of whom had undergone at least one previous abortion in which a laminaria was utilized, developed hypersensitivity reactions following laminaria placement. The reactions included urticaria, angioedema and respiratory distress. All responded to removal of the laminaria and administration of either diphenhydramine, prednisone, inhaled bronchodilators or subcutaneous epinephrine. One of the women subsequently underwent skin testing and was positive to laminaria. Patients undergoing laminaria placement may manifest a Type I reaction, IgE-mediated sensitivity. Providers should counsel patients with histories of multiple previous laminaria insertions about this possibility, have alternative methods of cervical dilation available, and be able to promptly recognize and treat reactions when they occur.
Chanda
M
M
Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada. 3mnc3@qlink.queensu.ca
Mackenzie
P
P
Day
J H
JH
D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002170:Canada; D004155:Diphenhydramine / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000188:drug therapy / Q000209:etiology*; D007795:Laminaria; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy
D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D004155:Diphenhydramine; D011241:Prednisone; D004837:Epinephrine