Amniotic fluid embolism

Balinger, Kathryn J.; Lam, Melissa T. Chu; Hon, Heidi H.; Stawicki, Stanislaw P; Anasti, James N.

doi:10.1097/gco.0000000000000218

Cited by 11 publications

(3 citation statements)

References 52 publications

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“…The most studied markers include elevated zinc coproporphyrin, a component of meconium, and serum sialyl-Tn, a fetal antigen present in both meconium and amniotic fluid [40,41]. Other biomarkers include decreased levels of C3, C3a, and C4, insulin-like growth factor binding protein, interleukins (IL) −6 and −8, tumor necrosis factor (TNF) alpha, endothelin, activin A and proopiomelanocortin (POMC) [42,43]. A prospective design for further studies on this pathology is difficult given its rarity and complex clinical presentation, but retrospective analyses could be performed in blood serums and/or histopathological probes stored in various biobases, and they could include novel biomarkers in order to evaluate their diagnostic accuracy and feasibility for use in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Considerations and Outcomes in Amniotic Fluid Embolism: A Retrospective Study over a 15-Year Period

Susanu,

Harabor,

Vicoveanu

et al. 2024

JCM

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(1) Background: A rare and unexpected consequence of childbirth, labor, or the immediate postpartum period is amniotic fluid embolism (AFE). This study aims to identify AFE cases during or immediately after birth from anesthetic management perspectives. Secondary goals include assessing patient clinical features, obstetric care techniques, birth outcomes, and case survival. (2) Methods: A retrospective observational study assessed AFE patients hospitalized in three Romanian clinical institutions from October 2007 to April 2023. Based on the Society of Maternal-Fetal Medicine (SMFM) criteria, we diagnosed 11 AFE patients. (3) Results: AFE occurred in eight cases (73%) during peripartum, two (18%) within 30 min after placental delivery, and 1 (9%) during a scheduled cesarean surgery. Only one of six cardiorespiratory arrest patients responded to external cardiac massage, while the other five (83%) needed defibrillation. The patients received, on average, five units of red blood cells, six of fresh frozen plasma, and two of activated platelets. Six patients (55%) received factor VIIa infusions. Maternal mortality was 36.3%. Six neonates (75%) needed neonatal resuscitation, and two (25%) died on the second and third days. (4) Conclusions: AFE management necessitates a multidisciplinary approach and the incorporation of advanced life support techniques to optimize outcomes for both the mother and newborn.

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Section: Discussionmentioning

confidence: 99%

Anesthetic Considerations and Outcomes in Amniotic Fluid Embolism: A Retrospective Study over a 15-Year Period

Susanu,

Harabor,

Vicoveanu

et al. 2024

JCM

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“…In the second stage, the patient's left ventricular function decreases and acute pulmonary edema develops in the lungs. In the third stage patients have coagulopathy, heart failure, acute lung injury and acute respiratory distress syndrome (ARDS) [8]. In addition, if the fetal is not delivered at the time of AFE, the fetal heart rate may be abnormal.…”

Section: Symptoms Of the Onset Of Amniotic Fluid Embolismmentioning

confidence: 99%

The Science of Amniotic Fluid Embolism

Xu¹

2023

HSET

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With many countries around the world facing aging populations and declining birth rates, governments are encouraging women to have children. However, few countries are really concerned about the effects of pregnancy on women, and society is hiding the risks and symptoms of pregnancy and postpartum complications as if to get more women to have children by hiding these facts. What I believe is that only when women truly understand the process and risk factors of pregnancy can they be prepared to give birth with confidence. People are always afraid of the unknown. This article systematically analyzes the disease with the highest mortality rate during pregnancy, amniotic fluid embolism (AFE). Hopefully, this article will make more people aware of this rare but highly fatal disease. This article introduces various aspects of AFE, the most central part of which should be the analysis of the causes of AFE and the current treatment methods. The author hopes that after reading this article, the reader will be able to eliminate as many questions as possible about AFE.

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“…Amniotic fluid embolism (AFE), or anaphylactoid syndrome of pregnancy, is a proinflammatory, anaphylactic-like reaction that can occur when the amniotic fluid enters the maternal blood circulation [ 1 , 2 ]. AFE is a rare complication (with a frequency of about 1 per 10–40 thousand births), but it is one of the main causes of maternal mortality in developed countries, with a mortality rate of 20–60% [ 3 , 4 , 5 , 6 , 7 ]. Although a rare complication of pregnancy, the high rates of injury for both the mother and the newborn provide a compelling argument to gain a better understanding of the mechanism of this disease [ 3 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Shock-Associated Systemic Inflammation in Amniotic Fluid Embolism, Complicated by Clinical Death

et al. 2023

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Background: Amniotic fluid embolism (AFE) is one of the main causes of maternal mortality in developed countries. The most critical AFE variants may be considered from the perspective of systemic inflammation (SI), a general pathological process that includes high levels of systemic inflammatory response, neuroendocrine system distress, microthrombosis, and multiple organ dysfunction syndrome (MODS). This research work aimed to characterize the dynamics of super-acute SI using four clinical case studies of patients with critical AFE. Methods: In all the cases, we examined blood coagulation parameters, plasma levels of cortisol, troponin I, myoglobin, C-reactive protein, IL-6, IL-8, IL-10, and TNF-α, and calculated the integral scores. Results: All four patients revealed the characteristic signs of SI, including increased cytokine, myoglobin, and troponin I levels, changes in blood cortisol, and clinical manifestations of coagulopathy and MODS. At the same time, the cytokine plasma levels can be characterized not only as hypercytokinemia, and not even as a “cytokine storm”, but rather as a “cytokine catastrophe” (an increase of thousands and tens of thousands of times in proinflammatory cytokine levels). AFE pathogenesis involves rapid transition from the hyperergic shock phase, with its high levels of a systemic inflammatory response over to the hypoergic shock phase, characterized by the mismatch between low systemic inflammatory response values and the patient’s critical condition. In contrast to septic shock, in AFE there is a much more rapid succession of SI phases. Conclusion: AFE is one of the most compelling examples for studying the dynamics of super-acute SI.

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Amniotic fluid embolism

Cited by 11 publications

References 52 publications

Anesthetic Considerations and Outcomes in Amniotic Fluid Embolism: A Retrospective Study over a 15-Year Period

Anesthetic Considerations and Outcomes in Amniotic Fluid Embolism: A Retrospective Study over a 15-Year Period

The Science of Amniotic Fluid Embolism

Shock-Associated Systemic Inflammation in Amniotic Fluid Embolism, Complicated by Clinical Death

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