Amniotic fluid embolism

Sadera, Girendra; Vasudevan, Bharathram

doi:10.4103/2249-4472.155192

Cited by 9 publications

(10 citation statements)

References 42 publications

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“…Reduced concentrations of C3 and C4 in AFE, in conjunction with the presence of respiratory distress, make it highly likely that complement has an important role in the pathophysiology. 6,7 In addition, the activation of the coagulation cascade supports the immunological theory. This is not entirely understood, but the presence of tissue factor and plateletactivating factor, and complement activation, may have a role in the development of DIC.…”

Section: Clinical Scenariomentioning

confidence: 57%

“…It is suggested that its reliability as a confirmatory test is augmented by testing in conjunction with alpha-fetoprotein and fetal fibronectin. 6 Lastly, the histological diagnosis of AFE can be made, although findings are not pathognomonic, as they can occur in other settings. Fetal squames and hair can be found in postmortem histological samples from lungs, kidneys, brain, liver, and spleen.…”

Section: Diagnosismentioning

confidence: 99%

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Amniotic fluid embolism

2018

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Identify the risk factors for amniotic fluid embolism (AFE). Discuss the pathophysiological processes underlying the clinical features of AFE. Differentiate between more common causes of maternal collapse and AFE. Interpret different diagnostic tests in the context of AFE, including new markers and specialised investigations. Implement prompt management of a woman suspected to have AFE. Amniotic fluid embolism (AFE) is a serious but rare complication of pregnancy with significant morbidity and mortality. AFE can present as a sudden and unexplained maternal collapse secondary to profound hypotension or hypoxaemia, and disseminated intravascular coagulation (DIC). Its rarity makes it difficult to study, and this is the main reason for gaps in our understanding of the condition. Since 2005, the UK Obstetric Surveillance System (UKOSS) has collected data on all AFE cases in the United Kingdom.

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Section: Clinical Scenariomentioning

confidence: 57%

Section: Diagnosismentioning

confidence: 99%

Amniotic fluid embolism

2018

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“…Because DIC and hemorrhage may occur in a significant proportion of AFE cases, aggressive blood and component replacements may become necessary. Recently, recombinant factor VIIa has been tried in such scenarios, but was associated with worse outcomes and thus is no longer recommended [41,42]. C1INH concentrates have been shown to revert hereditary angioedema in C1INH deficient patients; thus the administration of C1INH may turn out to be a promising treatment in some cases of AFE [1].…”

Section: Clinical Mangement Of Amniotic Fluid Embolismmentioning

confidence: 97%

Amniotic fluid embolism

Balinger¹,

Lam

Hon³

et al. 2015

Current Opinion in Obstetrics &Amp; Gynecology

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Although AFE cannot be prevented, early diagnosis and intervention may lead to better outcomes for both the mother and the fetus. Clinical suspicion, traditional laboratory data, or intravascular cellular debris (demonstrated only in 50% of patients) are insufficient to make a definitive diagnosis of AFE. An evolving array of novel biomarkers may help differentiate AFE from other conditions, but none of them currently provide sufficient 'early warning' ability to make real-time impact on diagnosis and/or treatment of AFE.

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“…Insidensi emboli air ketuban sulit untuk ditentukan karena (1) EAK adalah diagnosis eksklusi, (2) tidak ada definisi yang diterima secara seragam untuk identifikasi kasus EAK, dan (3) perbedaan metode penegakan diagnosis. 4 Insidensi EAK diperkirakan terjadi antara 1 dari 8000 dan 1 dari 80000 persalinan. Insidensi pastinya masih belum diketahui karena diagnosis yang tidak akurat dan pelaporan yang tidak konsisten untuk kasus nonfatal.…”

Section: Epidemiologiunclassified

Emboli Air Ketuban

Apsari

Suwondo

2020

JAOI

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Emboli cairan amnion (EAK) adalah komplikasi kehamilan yang jarang namun membawa angka mortalitas yang tinggi. Patogenesis yang tepat dari kondisi ini masih belum diketahui. Emboli air ketuban (EAK) atau amniotic fluid embolism (AFE) atau anaphylactoid syndrome of pregnancy adalah salah satu komplikasi kehamilan yang paling membahayakan. Cairan ketuban, debris fetal diduga menyebabkan kolaps kardiovaskular dengan cara memicu reaksi imun/anafilaktoid maternal. Patofisiologi EAK hingga kini masih belum jelas tetapi diduga melibatkan kaskade immunologis. Kematian maternal bisa terjadi karena cardiac arrest mendadak, perdarahan karena koagulopati, dan kegagalan organ multipel dengan acute respiratory distess syndrome (ARDS). Gejala dan tanda EAK antara lain dispnea akut, batuk, hipotensi, sianosis, bradikardia fetal, ensefalopati, hipertensi pulmoner akut, koagulopati, dan sebagainya. Diagnosis EAK adalah bersifat klinis dan ditegakkan setelah menyingkirkan kemungkinan penyebab lain. Penatalaksanaan bersifat suportif dan memerlukan persalinan janin jika diperlukan, support respiratorik, dan support hemodinamik. Prognosis maternal setelah EAK masih sangat buruk meski tingkat survival janin sekitar 70%. Pasien dengan EAK paling baik dikelola di unit perawatan kritis oleh tim multidisiplin dan dengan manajemen supportif. Amniotic Fluid Embolism Abstract Amniotic fluid embolism (AFE) is a rare complication of pregnancy carrying a high mortality rate. The exact pathogenesis of the condition is still not known. Amniotic fluid embolism (AFE) or anaphylactoid syndrome of pregnancy is one of the most dangerous pregnancy complications. Amniotic fluid, fetal debris is thought to cause cardiovascular collapse by triggering a maternal immune / maternal anaphylactoid reaction. The pathophysiology of AFE remains unclear but is thought to involve an immunological cascade. Maternal deaths may occur due to sudden cardiac arrest, bleeding due to coagulopathy, and multiple organ failure with ARDS. AFE symptoms and signs include acute dyspnea, cough, hypotension, cyanosis, fetal bradycardia, encephalopathy, acute pulmonary hypertension, coagulopathy. Management is supportive, respiratory support, and haemodynamic support. The maternal prognosis is very poor even though the survival rate of the fetus is about 70%. Patients with AFE are best managed in a critical care unit by a multidisciplinary team and management is largely supportive

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Amniotic fluid embolism

Cited by 9 publications

References 42 publications

Amniotic fluid embolism

Amniotic fluid embolism

Amniotic fluid embolism

Emboli Air Ketuban

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