Landmark article, Oct. 1941: Maternal pulmonary embolism by amniotic fluid as a cause of obstetric shock and unexpected deaths in obstetrics. By Paul E. Steiner and C. C. Lushbaugh

Steiner, Paul E.

doi:10.1001/jama.255.16.2187

Cited by 82 publications

(98 citation statements)

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“…At that time, Steiner and Lushbaugh reported cases of unexpected death in the obstetrical population and reviewed their clinical presentation and histopathological findings. 2 Of these, eight patients became the major focus of their discussion. These women were found to have material consistent with amniotic fluid debris in the pulmonary vasculature and consequently became the basis of the earliest descriptions of the amniotic fluid embolus syndrome.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Amniotic fluid embolus: a review of the literature

Davies

2001

Can J Anesth/J Can Anesth

111

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88Purpose: To review the literature since 1979 to determine the natural history, etiology, diagnosis and potential treatment of amniotic fluid embolus (AFE).Source: English language articles and books published between June 1976 and June 1998 were identified by a computerized medline search using the title or text word amniotic fluid embolus. This same search strategy was repeated and updated to October 1999 by an independent individual using both Medline and Embase. The search was also expanded to include Science Citation Index listing Morgan's 1979 review article. All relevant publications were retrieved and their bibliographies were scanned for additional sources.Principal findings: Randomized controlled trials are not possible with amniotic fluid emboli. The majority of the literature consists of clinical reports combined with occasional limited reviews. Knowledge obtained from these reports suggests that amniotic fluid emboli present as a spectrum of disease that ranges from a subclinical entity to one that is rapidly fatal. Because cases are sporadic and the diagnosis is often unconfirmed, little progress has been made towards understanding its etiology or defining the risk factors. Present management is empirical and directed towards the maintenance of oxygenation, circulatory support and the correction of coagulopathy.Conclusion: Amniotic fluid embolus continues to be a life-threatening but potentially reversible complication unique to pregnancy. It cannot be predicted nor prevented. Review of the literature reveals that there are no standardized investigational methods or protocols to confirm the diagnosis in suspected cases.Objectif : Passer en revue la littérature depuis 1979 pour déterminer l'histoire naturelle, l'étiologie, le diagnostic et le traitement potentiel d'une embolie amniotique (EA).Source : Des articles et des livres de langue anglaise, publiés entre juin 1976 et juin 1998, ont été sélectionnés lors d'une recherche informatisée de données médicales en utilisant les titres ou l'expression amniotic fluid embolus. La même méthode de recherche a été utilisée par un individu indépendant pour obtenir une mise à jour jusqu'en octobre 1999 avec Medline et Embase. La recherche a été étendue au Science Citation Index qui présentait la revue de Morgan de 1979. Tous les articles pertinents ont été retenus et leurs bibliographies examinées pour découvrir des sources supplémentaires.Constatations principales : Les essais contrôlés et randomisés sur l'embolie amniotique sont impossibles. La plus grande partie de la documentation constituée de résumés cliniques combinés à des revues limitées occasionnelles. Les connaissances dégagées de ces résumés suggèrent que l'embolie amniotique se présente comme de multiples affections allant de l'entité subclinique à la maladie rapidement fatale. Les cas étant rares et le diagnostic souvent non confirmé, peu de progrès ont été réalisés pour mieux en comprendre les causes ou pour définir ses facteurs de risque. Le traitement actuel est empirique et vise à maintenir...

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Section: Discussionmentioning

confidence: 99%

“…2 The syndrome was thought to more likely occur in the elderly multiparous patient who had an unusually strong or rapid labour or who had just delivered following such a labour. The use of uterine stimulants, meconium staining of the amniotic fluid or the presence of a large or dead fetus were also felt to increase the risk.…”

Section: Clinical Presentationmentioning

confidence: 99%

Amniotic fluid embolus: a review of the literature

Davies

2001

Can J Anesth/J Can Anesth

111

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“…AFE is responsible for significant proportion of maternal mortality (Lang & King, 2008;Lewis, 2007). The presence of fetal debris in the pulmonary circulation of a mother who died suddenly during labor was first reported by Meyer in 1926(Meyer, 1926 and subsequently by Steiner and Lushbaugh in 1941 as an autopsy series (Steiner & Lushbaugh, 1941).…”

Section: Amniotic Fluid Embolismmentioning

confidence: 92%

Non-Thrombotic Pulmonary Embolism

Balasubramanian¹,

Aparnath²,

Mathur³

2012

Pulmonary Embolism

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“…The history of attempts to treat AFE with heparin goes back to the first years after the famous description of this complication by Steiner and Lusbaugh in 1941 [15]. In 1953, Reid, Weiner and Roby [16] suggested in their case report that intravascular clotting, afibrinogenemia and postpartum bleeding associated with AFE were caused by amniotic TF.…”

Section: Attempts At Heparin Therapy Of Afementioning

confidence: 99%

Heparin and other anticoagulants in amniotic fluid embolism (AFE): Literature review and concept of the therapy

Uszyński¹,

Uszyński²

2013

OJOG

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Aim: The objective of this study is to review all the reported outcomes of heparin application in amniotic fluid embolism (AFE) so far and to find out why, when and how heparin or other anticoagulants should be used in AFE. Material and methods: We searched Medline (from 1969 to 2011), using two key words: 1) amniotic fluid embolism; 2) amniotic fluid embolism and heparin. The search for the former produced 1127 replies, of which 208 were case reports of AFE. In response to the other key word, there were 94 articles. We looked through all the articles, selecting those relevant for our study. Results: In the years 1969-2011, 208 AFE cases were reported. Heparin (unfractionated heparin) or low molecular weight heparin (LMWH) was applied in 20 cases (9.6%), being the main drug in 11 cases (5.3%) and in 6 cases as a component of spectacular treatment of AFE (surgical treatment and extracorporal membrane oxygenation). In one of these cases anithrombin (AT) with LMWH was used. In one patient heparin therapy was considered to be unsuccessful and hence recombinant plasminogen activator (rt-PA) was instituted. All the patients survived. Conclusions: 1) The attempts to use heparin in AFE could be defined as promising, although the number of treated patients is too small for conclusion; 2) The postulate to use heparin at the very onset of AFE (a bolus of 10,000 U followed by monitored intravenous infusion) has serious justification: one of the pathways of AFE is the target for heparin (coagulation pathway).

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Landmark article, Oct. 1941: Maternal pulmonary embolism by amniotic fluid as a cause of obstetric shock and unexpected deaths in obstetrics. By Paul E. Steiner and C. C. Lushbaugh

Cited by 82 publications

References 0 publications

Amniotic fluid embolus: a review of the literature

Amniotic fluid embolus: a review of the literature

Non-Thrombotic Pulmonary Embolism

Heparin and other anticoagulants in amniotic fluid embolism (AFE): Literature review and concept of the therapy

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