Amniotic Fluid Embolism

Abstract

Pulmonary embolism is the leading cause of maternal death in the United States. Amniotic fluid embolism (AFE) represents the least preventable and most lethal of complications with a reported mortality of 86% and an associated fetal demise of 50%. Although it is widely accepted as a clinical entity, AFE is incompletely understood. A combination of clinical presentation, laboratory findings, and exclusion of other pathologies leads to the diagnosis of AFE. The mainstays of treatment are oxygenation, maintenance of cardiac output, and correction of coagulopathy. The prognosis for the patient experiencing AFE remains bleak because it is largely unpredictable and, except for supportive measures, cannot be corrected.

Amniotic Fluid Embolism

“…The exact mechanism of this anaphylactoid reaction to amniotic fluid is not clearly understood. Predisposing factors once considered to be associated with AFE include placental abruption, uterine overdistention, fetal death, trauma, turbulent labor oxytocin-stimulated labor, multiparity, male fetus, cesarean delivery, advanced maternal age, prolonged gestation, instrumental vaginal delivery, eclampsia, polyhydramnios, fetal distress, large fetal size, high cervical laceration, premature separation of the placenta and rupture of membranes (12)(13)(14)(15). The presence of a large or dead fetus and meconium staining of the amniotic fluid are also felt to increase the risk (5) ( Table 1).…”

Fruchtwasserembolie - Ein Fallbericht mit positivem Ausgang

“…Die Fruchtwasserembolie (FWE) ist ein seltenes, nicht vorhersehbares, lebensbedrohli'ches Ereignis. Die Hauptsymptome sind Kreislaufdysfunktion und Gerinnungsstörung bei einer hohen mütterlichen und kindlichen Letalität (16,18). Die FWE kann in jeder Phase der Schwangerschaft auftreten (1,10,15,17).…”