Successful Recovery from an Acute Kidney Injury due to Amniotic Fluid Embolism

Ihara, Katsuhito; Naito, Shotaro; Okado, Tomokazu; Rai, Tatemitu; Mori, Yutaro; Toda, Takayuki; Uchida, Shinichi; Sasaki, Sei; Matsui, Noriaki

doi:10.2169/internalmedicine.54.2348

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…The neurological sequels are the most prevalent amniotic fluid complications reported in observational studies, affecting between 24% and 50% of cases [6,18,19]. The neurological sequels are closely followed by renal failure [20,21], cardiovascular and pulmonary disorders [22,23], or infectious complications [24].…”

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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“…Despite various treatments, AFE patients still have difficulty maintaining long-term physiological stability. At the time of referral to our hospital, 2 women had a body temperature below 35 °C, which may have been caused by severe hemorrhage and massive transfusion [18]. Hypothermia can lead to decreased thrombin activity, decreased platelet function, decreased fibrinogen synthesis, and increased fibrinolysis [19].…”

Section: Discussionmentioning

confidence: 99%

Referral of Pregnant Women with Amniotic Fluid Embolism: A Retrospective, Descriptive Study

Qian,

Wang

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background: Amniotic fluid embolism (AFE) is an urgent, catastrophic obstetric complication, but not all medical settings are equipped to manage AFE. The purpose of this study is to summarize the experience of referral of women with AFE in order to save the lives of women and improve the prognosis. Methods: We retrospectively collected the demographic characteristics, delivery process, symptoms and test indicators at the onset of AFE, as well as the treatment status and outcomes after referral of women with AFE who were treated at our hospital from January 2015 to November 2022. We descriptively summarized and analyzed these data. Results: A total of 13 women with AFE transferred to our hospital were included in the study. After referral, 3 women (23.08%) eventually died. One of the deceased women presented with hypothermia (34.5 °C) at the time of referral, and all 3 fatalities had lactic acidosis (pH <7.35 and lactic acid ≥5 mmol/L) and hypofibrinogenemia (<2 g/L). All 13 women were in shock after referral to our hospital and 92.31% (12/13) of the women were diagnosed with multiple organ dysfunction (MODS) when they were discharged. The markers of heart failure were abnormally elevated in the 3 deceased women. Conclusions: Referral should be considered as soon as possible in women with lactic acidosis, hypofibrinogenemia, and hypothermia with AFE.

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“…It is recommended that management be focused on resuscitation via intravascular volume repletion, correcting coagulopathy with appropriate blood products, controlling hemorrhage, administering inotropic and vasopressor support, as well as methods to prevent multi-organ dysfunction such as renal replacement therapy (RRT) [8]. Ihara et al suggested that RRT may filter fetal remnants of amniotic fluid from maternal circulation, thus provide renal protection and prevention of disease progression [10]. Additionally, other novel approaches have successfully been shown to treat AFE, including plasmapheresis, ventricular assist devices, intra-aortic balloon pump, and ECMO [1].…”

Section: Discussionmentioning

confidence: 99%

Amniotic Fluid Embolism Treated with Veno-Arterial Extracorporeal Membrane Oxygenation

Gitman

Bachar

Mendenhall

2019

Case Reports in Critical Care

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Amniotic fluid embolism (AFE) is an extremely rare yet fatal obstetric emergency. AFE presents as sudden cardiovascular collapse after a breach of maternal-fetal membranes and is often complicated by severe coagulopathy. We present a case where an AFE was treated with veno-arterial extracorporeal membrane oxygenation (ECMO) to help overcome the acute cardiopulmonary insult. The use of echocardiography proved to be an invaluable tool to help guide treatment and optimal duration of ECMO in the face of severe coagulopathy.

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Successful Recovery from an Acute Kidney Injury due to Amniotic Fluid Embolism

Cited by 4 publications

References 15 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

Referral of Pregnant Women with Amniotic Fluid Embolism: A Retrospective, Descriptive Study

Amniotic Fluid Embolism Treated with Veno-Arterial Extracorporeal Membrane Oxygenation

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