Allergy-induced preterm labor after the ingestion of shellfish.
Preterm parturition is a syndrome caused by several mechanisms of disease, including intrauterine infection/inflammation, uteroplacental ischemia, uterine overdistension, cervical disease, maternal/fetal stress, abnormal allogeneic responses, allergic reactions, and unknown insults. An allergic-like mechanism was proposed as a potential etiology for the preterm parturition syndrome, based on the observation that eosinophils were present in the amniotic fluid in a fraction of women with preterm labor and a history of allergy, coupled with the observation that conditioned media from degranulated mast cells (the effector cells of type 1 hypersensitivity) induced contractility of human myometrial strips. This communication describes a case of a pregnant woman who had an allergic reaction and regular uterine contractions after the ingestion of lobster meat, to which she was known to be allergic. Preterm labor subsided after the treatment of antihistamines and steroids. The patient subsequently delivered at term. At follow-up, the child was diagnosed with atopy and asthma, and required frequent use of inhaled corticosteroids and beta-2 adrenergic agents. The immunological basis for preterm labor induced by an allergic-like reaction (hypersensitivity) is reviewed.
Romero
Roberto
R
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA. prbchiefstaff@med.wayne.edu
Kusanovic
Juan Pedro
JP
Muñoz
Hernan
H
Gomez
Ricardo
R
Lamont
Ronald F
RF
Yeo
Lami
L
D000328:Adult; D000818:Animals; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D002744:Chlorpheniramine / Q000627:therapeutic use; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008121:Nephropidae; D007752:Obstetric Labor, Premature / Q000178:diet therapy / Q000276:immunology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012758:Shellfish / Q000009:adverse effects*; D014590:Uterine Contraction
D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D002744:Chlorpheniramine; D001623:Betamethasone