Clinical characteristics of amniotic fluid embolism: An experience of 29 years

Abstract

AFE patients were classified into two types based on presenting signs and symptoms. Knowledge of the various initial symptoms of AFE enables a correct diagnosis.

Clinical course of disseminated intravascular coagulopathy‐type amniotic fluid embolism: A report of three cases

“…In case 2, the timing of treatment appeared to be appropriate, and therefore, this patient required a minimum amount of blood transfusion. It has been reported that hysterectomy should be considered early before the complete development of coagulopathy . Removal of the uterus, which is the location of the anaphylactic reaction in DIC‐type AFE, might improve coagulopathy.…”

“…Initial incoagulable bleeding in all cases resembled the initial symptom of uterine atony. 9 However, DIC-type AFE advances DIC predominantly in PPH because of the rapid consumption of coagulation factors. In cases of uterine atony, massive atonic bleeding results in consumption of coagulation factors, following DIC.…”

“…There have been few reports on AFE with presence of severe coagulopathy and incoagulable bleeding, and absence of cardiopulmonary symptoms or limited cardiopulmonary symptoms, followed by massive blood loss during delivery. [8][9][10][11] Kanayama et al 11 reported that there were few cases of severe coagulopathy followed by incoagulable bleeding due to AFE in cases of severe post-partum hemorrhage (PPH), in which fetal materials were detected in uterine microvessels. Such cases were referred to as disseminated intravascular coagulopathy (DIC)-type AFE.…”

Amniotic fluid embolism

“…Components of amniotic fluid can be determined with hematoxylin-and-eosin, alcian-phloxine-martius yellow (testing for mucin), cytokeratin AE1/AE3 (for squamous cells), ZnCp-1 (for meconium), and C5aR stain (for complement activation) [34][35][36]. It has been noted, however, that only about 50% of patients with AFE had detectable fetal debris present in maternal circulation [6,37].…”

Patent Highlights

“…Substantial redevelopment would be required if it were to be used in diabetes. Amniotic fluid embolism (AFE) is a rare and often undiagnosed cause of acute pulmonary hypertension in pregnancy and uncontrollable postpartum uterine hemorrhage, precipitated by an ingression of amniotic fluid into maternal blood [13,14]. While decreased levels of complement components C3 and C4 have been reported in AFE patients who subsequently develop disseminated intravascular coagulation, an involvement of C1 in AFE had not been described.…”