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Recognition and management of allergic disease during pregnancy

Michael Schatz, MD, MS
Section Editors
Bruce S Bochner, MD
Charles J Lockwood, MD, MHCM
Deputy Editor
Anna M Feldweg, MD


Pregnancy may be complicated by new-onset or pre-existing allergic disease, including rhinitis, urticaria, angioedema, or atopic dermatitis (AD). In contrast to asthma in pregnancy, relatively few studies have examined the management of other allergic disorders in pregnant women.

This topic reviews the recognition and management of rhinitis, urticaria, angioedema, and AD in pregnancy, as well as general principles of medication use during pregnancy. The diagnosis and management of asthma in pregnancy, anaphylaxis in pregnancy, the various dermatoses of pregnancy, and the management of allergic rhinitis in nonpregnant patients are discussed separately. (See "Physiology and clinical course of asthma in pregnancy" and "Management of asthma during pregnancy" and "Anaphylaxis in pregnant and breastfeeding women" and "Dermatoses of pregnancy" and "Pharmacotherapy of allergic rhinitis".)

General approach to treating allergy in pregnancy — In any form of allergic disease, a primary element of management is avoidance of the culprit allergen, when possible. Allergen avoidance is particularly important during pregnancy because the use of systemic medications should be minimized, if possible.

Women with significant allergic disease should ideally be evaluated before they become pregnant, so that any skin testing, challenge procedures, or other exposures that might be necessary for definitive diagnosis can be safely performed. This is especially important for women with the following:

Allergies to medications that may be needed during pregnancy, such as local anesthetics or drugs used in general anesthesia. (See "Perioperative anaphylaxis: Evaluation and prevention of recurrent reactions".)

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Literature review current through: Nov 2017. | This topic last updated: Oct 20, 2016.
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