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PubMed1977

[Unusual cases of maternal death caused by amniotic fluid embolism].

Five cases of amnion fluid embolism are reported. In the first case the cause of the death was the obstruction of the lung-vessels. In the lung tissue calcium embolia could also been detected. In the second case embolization started--at unruptured amnionsac--with ecclampsia-like convulsions, later it was followed by coagulopathia. In the third case amnion fluid embolism was complicated by coagulopathia. In the fourth case in addition to amnion fluid embolism endometritis purulenta complicated by endotoxinaemia and coagulopathia were also present. In all four cases rupture of the uterus was revealed. In the fifth case amnion fluid embolism developed without the rupture of the uterus. At the autopsy of cases of maternal death the possibility of amnion fluid embolism should always be considered. Although macroscopic changes seen at amnion fluid embolism are not pathognomic, when clinical and pathological symptoms of haemorrhagic diathesis are present, there always arises the suspicion of amnion fluid embolism. Since lungs are relatively resistant to putrefaction amnion fluid embolism in optimal cases can be diagnosed histologically even in exhumated lung specimen. Reliable diagnosis of amnion fluid embolism in cases of sudden maternal death gives possibility to exclude medical negligence.

Adult↗
PubMedDate not supplied

[Amniotic fluid embolism direct cause of maternal death. Clinical case report].

Embolic complications in pregnancy are not common, but require prompt attention due to their high mortality, with reports of numbers up to 80% in patients with presence of amniotic fluid embolism. Of the embolic complications, deep vein thrombosis is the most frequent and 15-24% of patients could present with amniotic fluid embolism. In the case of a 42-year-old female who had this syndrome, it was considered an obstetric catastrophe. A review of the world literature was carried out to report on the physiopathology of the case.

Adult↗
PubMed1996

Amniotic fluid embolism.

AFE, although rare, remains a significant cause of maternal mortality. Even with improvements in supportive care, the prognosis remains poor for mother and fetus. The guidelines presented may help the physician to recognize this condition when it occurs and give some direction for therapy.

Embolism, Amniotic Fluid↗
PubMed2004

Amniotic fluid embolism with second trimester pregnancy termination: a case report.

PURPOSE: Describe the diagnosis, clinical features, pathophysiology, treatment and anesthetic management of amniotic fluid embolism (AFE) in a patient undergoing second trimester pregnancy termination. CLINICAL FEATURES: A 30-yr-old gravida 2, para 1, woman was admitted for a dilatation and evacuation procedure for underlying intra-uterine fetal demise in her second trimester of pregnancy. Hypotension, shock, respiratory arrest, pulseless electrical activity, hemorrhage, disseminated intravascular coagulopathy, requiring cardiopulmonary resuscitation and blood transfusion complicated her intraoperative care. AFE was considered the most likely cause of this intraoperative event. CONCLUSIONS: It is now recognized that the pathophysiological features of AFE are similar to a type-1 hypersensitivity reaction ranging from mild systemic reaction to anaphylaxis and shock. AFE has a high maternal and fetal morbidity and mortality rate, requiring prompt recognition and treatment. In patients with cardiovascular instability, the treatment of AFE is similar to anaphylaxis requiring aggressive fluid hydration, cardiopulmonary resuscitation, administration of blood products and the use of vasopressors.

Adult↗
PubMed2004

[Fatal amniotic fluid embolism. Extraction by Caesarean section of a living child without neurological after-effects].

The authors report on the case of an amniotic fluid embolism, proven by post mortem, which was the result of an inaugural and irreversible cardiac arrest in a 37-year-old woman at 39 weeks of normal pregnancy. The Caesarean section was carried out as an extreme emergency in the labour room, while efforts were being made to resuscitate the mother, so as to deliver a living newborn without any neurological after-effects. The haemostatic consequences were showed up only on blood tests.

Adult↗
PubMedDate not supplied

Amniotic fluid embolism: maternal mortality revisited.

Amiotic fluid embolism is still a significant cause of maternal mortality. It must be suspected in all cases of sudden maternal collapse. For successful resuscitation, surgical delivery should be performed without delay.

Adult↗
PubMed1986

Analysis of a case of generalized amniotic fluid embolism by demonstrating the fetal isoantigen (A blood type) in maternal tissues of B blood type, using immunoperoxidase staining.

A case of generalized amniotic fluid embolism, confirmed by staining fetal isoantigen in the maternal tissues, is reported. The distribution of emboli may be more accurately evaluated with the immunochemical staining technic than with standard hematoxylin and eosin stain. The severity of the embolic state is evaluated very exactly.

ABO Blood-Group System↗
PubMed1994

Amniotic fluid embolism after saline amnioinfusion: two cases and review of the literature.

BACKGROUND: Amnioinfusion is an intrapartum intervention with proven benefit in certain clinical situations. It is thought to be a safe treatment with few adverse effects. CASES: Two cases of fatal amniotic fluid (AF) embolism occurred in women who were treated during labor with a saline amnioinfusion. In both cases, amnioinfusion was administered after finding thick meconium staining of the AF. In addition to the amnioinfusion, common factors in these cases and three previously reported AF embolisms associated with amnioinfusion are the presence of rapid labor, meconium-stained fluid, or both. CONCLUSIONS: Amniotic fluid embolism is a rare cause of maternal morbidity and mortality. It is not known whether amnioinfusion increases the rate of its occurrence in laboring patients. No change in clinical practice is warranted on the basis of these reports; however, future reports must be examined so that any common factors can be identified.

Adult↗
PubMed2004

Amniotic fluid embolism: an obstetric emergency.

AFE is an unpredictable, unpreventable, and, for the most part, an untreatable obstetric emergency. Management of this condition includes prompt recognition of the signs and symptoms, aggressive resuscitation efforts, and supportive therapy. Any delays in diagnosis and treatment can result in increased maternal and/or fetal impairment or death. Whereas once the invariable outcome of AFE was death of the mother, today the prognosis is somewhat brighter thanks to increased awareness of the syndrome and advances in intensive care medicine. In any case, intensive care nurses are called on to provide physical, life-saving care to the patient and her fetus. Both during and after the event, supportive care must be administered to the patient's family members, who are dealing with crisis and loss.

Critical Care↗
PubMedDate not supplied

Placenta previa and accreta complicated by amniotic fluid embolism.

BACKGROUND: The simultaneous occurrence of placenta previa and placenta accreta in patients who had previous low transverse cesarean delivery is presently well established. However, the sequence of previous cesarean delivery followed by placenta previa and accreta in a patient who also experiences a premature rupture of membranes as well as amniotic fluid embolism (AFE) is a rare obstetric phenomenon. CASE: A 24-year-old woman, para 2 with two previous cesarean deliveries, at 32 weeks' gestation by last menstrual period, was admitted with premature rupture of membranes. A repeat cesarean delivery (CD) was done. Excessive hemorrhage occurred, necessitating a hysterectomy. Also, the patient developed an amniotic fluid embolism. CONCLUSION: Placenta previa and placenta accreta may be observed in patients who have a previous CD scar and in whom AFE develops suddenly and unexpectedly. AFE, a condition with complex pathogenesis, presents a number of challenges, with the patient undergoing serious complications that may include massive hemorrhage, disseminated intravascular coagulopathy, and death. The obstetrician should be alert to the symptoms of AFE, and if they occur should begin prompt and aggressive treatment.

Adult↗
PubMed2005

Survival following amniotic fluid embolism and cardiac arrest complicated by sub-capsular liver haematoma.

We describe the anaesthetic and intensive care management of a 38-year-old mother with presumed amniotic fluid embolism who suffered cardiorespiratory collapse following delivery of a normal baby by caesarean section. After initial resuscitation, her recovery was complicated by development of disseminated intravascular coagulation and a large sub-capsular hepatic haematoma. We describe the initial resuscitative efforts and subsequent intensive therapy to full neurological recovery and discharge from hospital.

Adult↗