To the Editor: 

The recent article by Draisci et al.  1showing an increased incidence of increased serum concentrations of specific rubber latex immunoglobulin antibodies among pregnant women is very important. We were interested, however, to know whether the two patients who actually exhibited anaphylaxis had increased concentrations of latex immunoglobulin E antibodies and/or positive latex skin tests. In the methods, it is noted that “skin-prick tests and intradermal tests with oxytocin or other drugs administered in the study were performed to exclude drug allergy in patients who experienced adverse reactions.” It is possible that these two patients could have in fact been allergic to other allergens and this information was not reported. The treatment of anaphylaxis, especially in a pregnant patient with a potentially difficult airway, who is exhibiting facial edema and “throat closure,” may also require adrenaline and a low threshold for intubation.2It would also be of interest to know whether among the pregnant women with latex hypersensitivity the serum concentrations of rubber latex immunoglobulin E became normal after pregnancy. Although the reasons behind the increased serum concentrations of rubber latex immunoglobulin E, potentially increasing the incidence of latex hypersensitivity among pregnant women, are pure speculation, as discussed,1the danger is clear. The way to avoid this life-threatening problem altogether is to remove latex (gloves or catheters) from the operating room in the labor and delivery suite.

Draisci G, Zanfini BA, Nucera E, Catarci S, Sangregorio R, Schiavino D, Mannocci A, Patriarca G: Latex sensitization: A special risk for the obstetric population? ANESTHESIOLOGY 2011; 114:565–9
Weiniger CF, Levin PD: Anaphylaxis during cesarean section: The importance of a good history (abstract). Int J Obstet Anesth 2009; 18:S14