Evaluation of the 4 diagnosis criteria proposed by the SMFM and the AFE foundation for amniotic fluid embolism in a monocentric population

Ponzio-Klijanienko, A.; Vincent-Rohfritsch, A.; Girault, A.; Ray, Camille Le; Goffinet, François; Bonnet, Marie‐Pierre

doi:10.1016/j.jogoh.2020.101821

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…In most of the differential diagnoses, these criteria do not occur simultaneously. However, the research also shows that less than a half of women with AFE confirmed, presented them all [12]. Therefore, the diagnosis can only be made by excluding other possibilities [5,10].…”

Section: Discussionmentioning

confidence: 88%

“…It may occur during pregnancy, medical procedures such as amniocentesis, induction of labour, vaginal delivery, cesarean section or postpartum [4,10]. The incidence of the disease is estimated at 1,9-8 per 100,000 pregnancies [4][5][6][7][8][10][11][12][13][14][15]. It is characterized by poor maternal outcome with high fatality rate ranged from 20% to 60%, depending on country's level of development and the timing of the data [8,10,15].…”

Section: Discussionmentioning

confidence: 99%

“…Older data indicate a mortality reaching even about 90% [4,7]. AFE is an uncommon disease, but it causes up to 10% of all maternal deaths [12].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the diagnosis of AFE is very difficult, and the complication itself resembles other causes of the rapid deterioration of woman' s condition that may occur in the perinatal period, such as: acute pulmonary embolism by thrombus, anaphylaxis, cardiogenic shock, sepsis, air embolism or side effects of anesthetics [10,15]. To accelerate and facilitate the diagnosis of AFE, Society for Maternal-Fetal Medicine (SMFM) and Amniotic Fluid Embolism Foundation have recently proposed four diagnostic criteria: (1) sudden cardiac arrest or cardio-respiratory collapse, (2) clinical onset during labour or within half an hour of placental delivery, (3) DIC and (4) absence of fever (≥38°C) during labour [4,12,16]. Our patient had all of the above features.…”

Section: Discussionmentioning

confidence: 99%

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Acute Pulmonary Embolism by Amniotic Fluid – A Rare Complication of Perinatal Period That Should Not Be Forgotten

et al. 2021

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Amniotic fluid embolism (AFE) is a diagnostically challenging type of pulmonary embolism that occurs when amniotic fluid enters maternal circulation during delivery or postpartum. This obstetric complication is very rare but characterized by high mortality rate. The main symptoms are dyspnea, cardiovascular collapse, disseminated intravascular coagulation (DIC) and even sudden cardiac death. The aim of the article is to draw attention to AFE as a rare but possible and catastrophic complication of perinatal period. The authors present a 28-year-old woman who was admitted to obstetric ward during the first stage of labour. The patient developed sudden deterioration of her medical state with acute respiratory distress symptoms. An emergency cesarean section was performed, complicated by excessive bleeding. After a detailed assessment of the patient’s condition and evaluation of the results of additional tests, we diagnosed AFE as the cause of the patient’s deterioration. Conclusions: The case study shows how unpredictable, unpreventable and dangerous is AFE. It is still one of the main causes of maternal deaths in developed countries. Four diagnostic criteria proposed by the Society for Maternal-Fetal Medicine (SMFM) may accelerate diagnosis. AFE as a medical emergency, requires immediate multidisciplinary response and aggressive treatment. The initial medical care may be facilitated by the application of the general guidelines recommended by SMFM. The case report also emphasizes the need for further research on this disease, in particular on early detection and prevention.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

“…Older data indicate a mortality reaching even about 90% [4,7]. AFE is an uncommon disease, but it causes up to 10% of all maternal deaths [12].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute Pulmonary Embolism by Amniotic Fluid – A Rare Complication of Perinatal Period That Should Not Be Forgotten

et al. 2021

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“…However, as the disease progresses, the number of red blood cells also decreases. The diagnosis of AFE may be delayed by a lag in laboratory tests on coagulation function [ 4 ]. AFE diagnosis is a type of exclusive diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Can cell salvage be used for resuscitation in a patient with amniotic fluid embolism and hepatic laceration? A case report

Luo

et al. 2022

BMC Pregnancy Childbirth

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Background Amniotic fluid embolism (AFE) is a rare disease that can lead to profound coagulopathy and hemorrhage, especially when combined with the laceration and bleeding of other organs. Intraoperative cell salvage (ICS) has been widely used for treating obstetric hemorrhage, but it remains unclear whether ICS can be used in the treatment of AFE. Case presentation We report the case of a 27-year-old woman at 39 weeks’ gestation who suddenly developed severe abdominal pain, convulsions, loss of consciousness, and decreased vital signs during labor. Despite an emergency cesarean section being performed, the parturient experienced sudden cardiac arrest. Fortunately, the heart rate spontaneously recovered after effective cardiopulmonary resuscitation (CPR). Further abdominal exploration revealed right hepatic laceration with active bleeding. ICS was performed and the salvaged blood was promptly transfused back to the patient. Subsequently, the patient was diagnosed with AFE based on hypotension, hypoxia, coagulopathy, and cardiac arrest. The patient was transfused with 2899 mL salvaged blood during surgery with no adverse effects. At 60- and 90-day follow-ups, no complaints of discomfort or abnormal laboratory test results were observed in the mother or the baby. Conclusion ICS was used to rescue patient with AFE, and ICS did not worsen the condition of patients with AFE. For pregnant women who received CPR, clinicians should explore the presence of hepatic laceration which can be fatal to patients.

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28/w – G II P 0 mit Kreislaufkollaps/Schocksymptomatik unter Geburt

2020

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Evaluation of the 4 diagnosis criteria proposed by the SMFM and the AFE foundation for amniotic fluid embolism in a monocentric population

Cited by 17 publications

References 25 publications

Acute Pulmonary Embolism by Amniotic Fluid – A Rare Complication of Perinatal Period That Should Not Be Forgotten

Acute Pulmonary Embolism by Amniotic Fluid – A Rare Complication of Perinatal Period That Should Not Be Forgotten

Can cell salvage be used for resuscitation in a patient with amniotic fluid embolism and hepatic laceration? A case report

28/w – G II P 0 mit Kreislaufkollaps/Schocksymptomatik unter Geburt

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