Amniotic fluid embolism

Thongrong, Cattleya; Kasemsiri, Pornthep; Hofmann, J; Bergese, Sergio D.; Papadimos, Thomas J; Gracias, Vicente H.; Adolph, M.; Stawicki, Stanislaw P

doi:10.4103/2229-5151.109422

Cited by 14 publications

(3 citation statements)

References 48 publications

(77 reference statements)

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“…Although the specific function of tryptase in anaphylaxis is unknown, with a half-life measured in hours instead of the minutes of histamine, the protein has proven useful in the diagnosis of anaphylaxis. [ 36 ]…”

Section: Diagnosis[ 6 9 16 mentioning

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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Section: Diagnosis[ 6 9 16 mentioning

confidence: 99%

Amniotic fluid embolism

Kaur

Bhardwaj

Kumar

et al. 2016

J Anaesthesiol Clin Pharmacol

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“…In our case this intervention did not have positive effects on the mother but rather on the baby. The subsequent autopsy showed posttraumatic amniotic fluid embolism (AFE) [ 26 ] as the main cause of the death rather than massive abdominal hemorrhage. The deceleration of the mother's body inside the vehicle during the impact could be involved in the mechanism of injury, as demonstrated by Crosby and coworkers as far as 1968 [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest

Gatti

Spagnoli

Zerbi

et al. 2014

Case Reports in Emergency Medicine

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The optimal treatment of a severe hemodynamic instability from shock to cardiac arrest in late term pregnant women is subject to ongoing studies. However, there is an increasing evidence that early “separation” between the mother and the foetus may increase the restoration of the hemodynamic status and, in the cardiac arrest setting, it may raise the likelihood of a return of spontaneous circulation (ROSC) in the mother. This treatment, called Perimortem Cesarean Section (PMCS), is now termed as Resuscitative Hysterotomy (RH) to better address the issue of an early Cesarean section (C-section). This strategy is in contrast with the traditional treatment of cardiac arrest characterized by the maintenance of cardiopulmonary resuscitation (CPR) maneuvers without any emergent surgical intervention. We report the case of a prehospital perimortem delivery by Caesarean (C) section of a foetus at 36 weeks of gestation after the mother's traumatic cardiac arrest. Despite the negative outcome of the mother, the choice of performing a RH seems to represent up to date the most appropriate intervention to improve the outcome in both mother and foetus.

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“…[ 68 ] This devastating pathophysiologic entity continues to be a diagnosis of exclusion, with sepsis, pulmonary embolism, and other acute cardio-pulmonary disorders competing for the bedside clinician's attention. [ 69 ] Development of a sensitive and specific biomarker for AFE may provide an opportunity not only for early diagnosis, but much more importantly for earlier and more effective clinical intervention. [ 68 ]…”

Section: Obstetrics and Gynecologymentioning

confidence: 99%

Academic college of emergency experts in India′s indo-us joint working group and opus12 foundation consensus statement on creating a coordinated, multi-disciplinary, patient-centered, global point-of-care biomarker discovery network

Stawicki

Stoltzfus

Aggarwal

et al. 2014

Int J Crit Illn Inj Sci

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Biomarker science brings great promise to clinical medicine. This is especially true in the era of technology miniaturization, rapid dissemination of knowledge, and point-of-care (POC) implementation of novel diagnostics. Despite this tremendous progress, the journey from a candidate biomarker to a scientifically validated biomarker continues to be an arduous one. In addition to substantial financial resources, biomarker research requires considerable expertise and a multidisciplinary approach. Investigational designs must also be taken into account, with the randomized controlled trial remaining the “gold standard”. The authors present a condensed overview of biomarker science and associated investigational methods, followed by specific examples from clinical areas where biomarker development and/or implementation resulted in tangible enhancements in patient care. This manuscript also serves as a call to arms for the establishment of a truly global, well-coordinated infrastructure dedicated to biomarker research and development, with focus on delivery of the latest discoveries directly to the patient via point-of-care technology.

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Amniotic fluid embolism

Cited by 14 publications

References 48 publications

Amniotic fluid embolism

Amniotic fluid embolism

Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest

Academic college of emergency experts in India′s indo-us joint working group and opus12 foundation consensus statement on creating a coordinated, multi-disciplinary, patient-centered, global point-of-care biomarker discovery network

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