Amniotic Fluid Embolism

Toy, Harun

doi:10.29333/ejgm/82650

Cited by 11 publications

(15 citation statements)

References 50 publications

(54 reference statements)

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“…[ 5 6 7 8 ] In some women, AFE may lead to a mild degree of organ dysfunction while in others it may lead to coagulopathy, cardiovascular collapse, and death. [ 9 10 ]…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid embolism

Kaur

Bhardwaj

Kumar

et al. 2016

J Anaesthesiol Clin Pharmacol

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Amniotic fluid embolism (AFE) is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse. Etiology largely remains unknown, but may occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the second trimester of pregnancy. It may also occur up to 48 hours post-delivery. It can also occur during abortion, after abdominal trauma, and during amnio-infusion. The pathophysiology of AFE is not completely understood. Possible historical cause is that any breach of the barrier between maternal blood and amniotic fluid forces the entry of amniotic fluid into the systemic circulation and results in a physical obstruction of the pulmonary circulation. The presenting signs and symptoms of AFE involve many organ systems. Clinical signs and symptoms are acute dyspnea, cough, hypotension, cyanosis, fetal bradycardia, encephalopathy, acute pulmonary hypertension, coagulopathy etc. Besides basic investigations lung scan, serum tryptase levels, serum levels of C3 and C4 complements, zinc coproporphyrin, serum sialyl Tn etc are helpful in establishing the diagnosis. Treatment is mainly supportive, but exchange transfusion, extracorporeal membrane oxygenation, and uterine artery embolization have been tried from time to time. The maternal prognosis after amniotic fluid embolism is very poor though infant survival rate is around 70%.

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“…[ 5 6 7 8 ] In some women, AFE may lead to a mild degree of organ dysfunction while in others it may lead to coagulopathy, cardiovascular collapse, and death. [ 9 10 ]…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid embolism

Kaur

Bhardwaj

Kumar

et al. 2016

J Anaesthesiol Clin Pharmacol

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“…The pathogenesis of AFE is not yet fully clear. Amniotic fluid can enter the maternal circulation via endocervical veins, lesions of the uterus, or the site of placental attachment (16).…”

Section: Pathogenesismentioning

confidence: 99%

“…Evidence of fetal cells in the pulmonary vessels is not a reliable diagnostic criterion and is not pathognomonic for AFE, as fetal cells can be detected in 21% to 100% of pregnant woman without AFE (6). Promising diagnostic markers of AFE such as zinc coproporphyrin, sialyl-Tn antigen, tryptase, or C 3 and C 4 complement and detection of insulin-like growth factor binding protein-1 (e16) have not been established in routine clinical diagnosis (6,16). Hemodynamic parameters, ECG, blood gas analysis, chest X-ray, and laboratory tests (including blood count, cardiac enzymes, and coagulation tests) and specific tests such as transesophageal echocardiography (TEE) and rotational thromboelastometry are less useful for confirming diagnosis but much more so for monitoring and treatment optimization.…”

Section: Diagnosismentioning

confidence: 99%

Amniotic Fluid Embolism

Rath

Hoferr²,

Sinicina³

2014

Deutsches Ärzteblatt International

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“…[6] Despite relatively unchanged incidence, it has been noted that the mortality associated with AFE has decreased significantly in the recent past. [7]…”

Section: Incidence Of Amniotic Fluid Embolismmentioning

confidence: 99%

“…We also highlight the critical care aspects of affected patient care, and focus on the high index of clinical suspicion required to promptly recognize and treat this cause of 10-26% of maternal deaths. [378]…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid embolism

Thongrong

Kasemsiri

Hofmann

et al. 2013

Int J Crit Illn Inj Sci

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Amniotic fluid embolism (AFE) is an unpredictable and as-of-yet unpreventable complication of maternity. With its low incidence it is unlikely that any given practitioner will be confronted with a case of AFE. However, this rare occurrence carries a high probability of serious sequelae including cardiac arrest, ARDS, coagulopathy with massive hemorrhage, encephalopathy, seizures, and both maternal and infant mortality. In this review the current state of medical knowledge about AFE is outlined including its incidence, risk factors, diagnosis, pathophysiology, and clinical manifestations. Special attention is paid to the modern aggressive supportive care that resulted in an overall reduction in the still alarmingly high mortality rate of this devastating entity. The key factors for successful management and resolution of this disease process continue to be sharp vigilance, a high level of clinical suspicion, and rapid all-out resuscitative efforts on the part of all clinicians involved in the medical care of the parturient.

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Amniotic Fluid Embolism

Abstract: Amniotic fluid embolism (AFE) is

Cited by 11 publications

References 50 publications

Amniotic fluid embolism

Amniotic fluid embolism

Amniotic Fluid Embolism

Amniotic fluid embolism

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