Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism

Collins, N F; Bloor, Melanie; McDonnell, Nolan

doi:10.1016/j.ijoa.2012.09.008

Cited by 42 publications

(16 citation statements)

References 25 publications

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“…Collins et al observed primary fibrinolysis and treated it with antifibrinolytics [3]. As opposed to Annecke and Collins, who interpreted their first trace as hyperfibrinolysis, we did not use antifibrinolytic agents, but rather plasma and cryoprecipitate, and our results were similar to Annecke's and Collins's second traces.…”

Section: Discussionsupporting

confidence: 77%

“…After treating her with tranexamic acid and infusion of blood products, there was clot formation with prolonged clotting time (correspond to R of the TEG), and low maximal clot strength (similar to MA of the TEG). Collins et al presented a case of suspected amniotic fluid emboli and hemodynamic collapse after cesarean section [3]. The ROTEM results had shown hyperfibrinolysis and low fibrinogen.…”

Section: Discussionmentioning

confidence: 99%

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Thromboelastography as a part of management of amniotic fluid embolism

Helviz

Einav

Hersch

et al. 2014

Case Reports in Perinatal Medicine

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Amniotic fluid embolism (AFE) is an obstetrical catastrophe characterized by acute hypotension, hypoxia, and coagulopathy occurring during labor, cesarean section, post-delivery, or during amniocentesis. Thromboelastography (TEG) is a bedside test of global homeostasis and has seldom been used to study coagulation in AFE despite increasing popularity in other diseases. We report TEG usage as part of a treatment for patients with AFE.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Thromboelastography as a part of management of amniotic fluid embolism

Helviz

Einav

Hersch

et al. 2014

Case Reports in Perinatal Medicine

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“…When available, bedside thromboelastography may aid in identifying bleeding patients who might benefit from the use of antifibrinolytics such as tranexamic acid or epsilon aminocaproic acid. 30 Uterine atony is common with amniotic fluid embolism and should be managed aggressively. 31 The use of uterotonics such as oxytocin, ergot derivatives, and prostaglandins is appropriate when indicated.…”

Section: Components Of High-quality Cardiopulmonary Resuscitation In mentioning

confidence: 99%

Amniotic fluid embolism: diagnosis and management

Pacheco

Saade

Hankins

et al. 2016

American Journal of Obstetrics and Gynecology

134

139

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We recommend the following: (1) we recommend consideration of amniotic fluid embolism in the differential diagnosis of sudden cardiorespiratory collapse in the laboring or recently delivered woman (GRADE 1C); (2) we do not recommend the use of any specific diagnostic laboratory test to either confirm or refute the diagnosis of amniotic fluid embolism; at the present time, amniotic fluid embolism remains a clinical diagnosis (GRADE 1C); (3) we recommend the provision of immediate high-quality cardiopulmonary resuscitation with standard basic cardiac life support and advanced cardiac life support protocols in patients who develop cardiac arrest associated with amniotic fluid embolism (GRADE 1C); (4) we recommend that a multidisciplinary team including anesthesia, respiratory therapy, critical care, and maternal-fetal medicine should be involved in the ongoing care of women with AFE (Best Practice); (5) following cardiac arrest with amniotic fluid embolism, we recommend immediate delivery in the presence of a fetus ≥23 weeks of gestation (GRADE 2C); (6) we recommend the provision of adequate oxygenation and ventilation and, when indicated by hemodynamic status, the use of vasopressors and inotropic agents in the initial management of amniotic fluid embolism. Excessive fluid administration should be avoided (GRADE 1C); and (7) because coagulopathy may follow cardiovascular collapse with amniotic fluid embolism, we recommend the early assessment of clotting status and early aggressive management of clinical bleeding with standard massive transfusion protocols (GRADE 1C).

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“…To date, there are only 2 published cases of AFE diagnosis confirmed with the aid of TEG [9][10] . In our case, TEG was used for rapid confirmation of coagulopathy, thus confirming our diagnosis of AFE.…”

Section: Discussionmentioning

confidence: 99%

Amniotic Fluid Embolism: A Rare Complication of Second-Trimester Amniocentesis

Drukker

Sela²,

Ioscovich³

et al. 2016

Fetal Diagn Ther

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Amniotic fluid embolism occurring following diagnostic amniocentesis is extremely rare. Only 2 cases have been reported in the English literature over the past 55 years, the most recent one approximately 3 decades ago. We present a case of amniocentesis at 24 weeks' gestation that was performed as part of an evaluation of abnormal fetal ultrasound findings. Immediately following amniotic fluid aspiration, maternal hemodynamic collapse occurred, initially diagnosed and treated as anaphylactic shock. Shortly after initial therapy, coagulopathy was noted and amniotic fluid syndrome suspected. Rapid response restored maternal hemodynamic stability; however, the fetus had suffered fatal damage.

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Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism

Cited by 42 publications

References 25 publications

Thromboelastography as a part of management of amniotic fluid embolism

Thromboelastography as a part of management of amniotic fluid embolism

Amniotic fluid embolism: diagnosis and management

Amniotic Fluid Embolism: A Rare Complication of Second-Trimester Amniocentesis

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