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PubMed2002

[Amniotic fluid embolism during labor].

Amniotic fluid embolism is an unpredictable but dramatical complication of pregnancy that occurs when amniotic fluid enter into the maternal circulation. The classical clinical feature is acute respiratory distress, circulatory distress, seizures and coagulopathy. However there is no routine laboratory diagnosis, so that is a diagnosis of exclusion. We report here the case of a patient, on labor with an epidural analgesia who suddenly suffered from seizures, circulatory arrest, and haemorrhage. A symptomatic management was instituted and a caesarean section was performed. An haemostatic hysterectomy was required. The patient survived without any sequelae. Neurological outcome of the child is still reserved.

Adult↗
PubMedDate not supplied

Amniotic fluid embolism. A case report.

Amniotic fluid embolism is a rare, yet catastrophic event. In the United States it occurs in 1 per 20,000 to 30,000 births. With an 86% maternal mortality rate, amniotic fluid embolism is responsible for 10-15% of all maternal deaths. This article presents a case study of a CNM's experience with a maternal and fetal death resulting from an amniotic fluid embolism. Pathogenesis and appropriate management are also presented.

Embolism, Amniotic Fluid↗
PubMed1985

Hemodynamic alterations associated with amniotic fluid embolism: a reappraisal.

Experimental amniotic fluid embolism in animals produces profound pulmonary hypertension and acute cor pulmonale without evidence of left ventricular compromise. Authors reporting hemodynamic alterations associated with clinical amniotic fluid embolism have traditionally attempted to explain their findings within this experimental framework. A reanalysis of the five published cases of amniotic fluid embolism, which include hemodynamic data derived from pulmonary artery catheterization as well as a report of a sixth case suggests a hemodynamic interpretation different from the traditional one based on the animal model. Left ventricular failure is the only hemodynamic abnormality consistently observed in humans, and the published data are most readily explained on this basis alone. A theoretical model of hemodynamic changes accompanying amniotic fluid embolism that incorporates both experimental and clinical observations is presented. Therapeutic implications are discussed.

Adult↗
PubMed2004

Amniotic fluid embolism during caesarean section.

Amniotic fluid embolism occurs rarely but is a leading cause of maternal mortality. A high index of clinical suspicion is necessary to make an early diagnosis to reduce morbidity and mortality. We report a non-fatal case of amniotic fluid embolism occurring during a caesarean section, with special emphasis on the mode of development and diagnosis. The initial presentation of this syndrome was a coagulopathy, followed by the usual complications of massive bleeding. Although non-specific, the diagnosis of amniotic fluid embolism was supported by the observation of amniotic fluid in the central venous blood as well as in the broncho-alveolar fluid.

Adult↗
PubMed1979

Amniotic fluid embolism.

The statement that amniotic fluid embolism is the most dangerous and untreatable condition in obstetrics appears to be true. It must be suspected in any patient who collapses or bleeds excessively during labour or the immediate post-partum period. Attempts should be made to secure a definitive diagnosis in life by examination of blood obtained from the right side of the heart and the sputum for elements of amniotic fluid. Lung scanning is a useful aid to diagnosis. The principal factors that have been implicated in the clinical syndrome of amniotic fluid embolism are anaphylaxis, vascular obstruction by particulate matter, vascular spasm due to prostaglandins and possibly some other vasoactive substances, and the possibility that all the changes could be explained by disseminated intravascular coagulation as a primary event. Further work is required to elucidate the relative contributions of these various factors. Due to the suddeness of the catastrophe and the very high mortality, haemodynamic data in humans is virtually non-existent. With improved methods of resuscitation it is to be hoped that the mortality rate will be reduced and that such data will become available. In this way it might become possible to apply the results of animal research and indicate the most effective method of treatment.

Adolescent↗
PubMed1985

Amniotic fluid embolism in Sweden, 1951-1980.

Amniotic fluid embolism is one of the least frequent complications of parturition, but the most dangerous of all. 38 cases of fatal amniotic fluid embolism were diagnosed in Sweden during the years 1951-1980, i.e. 1 case for every 83,000 live births. The proportion of amniotic fluid embolism in maternal mortality as a whole increased from 1.2 to 16.5% during this period. Predisposing factors identified were gemini/polydyramnios, abruptio placentae, hypertonic labor, rupture of the birth canal, macrosomia, and obstetrical interventions such as administration of oxytocin and fundal pressure. The main symptoms were cardiovascular shock with right heart strain, and hemorrhage with pathologic proteolysis. Four cases of presumed amniotic fluid embolism with survival of the patient were diagnosed during the years 1972-1980--a case fatality rate of 66% (4/12).

Adult↗
PubMed1988

[Amniotic fluid embolism].

A case of amniotic fluid embolism during the second stage of labor is reported. Mother and newborn survived. Etiology, symptoms and therapy are discussed.

Adult↗
PubMed1983

Amniotic fluid embolism after transabdominal amniocentesis.

Amniotic fluid embolism following transabdominal amniocentesis is a very rare and mostly fatal event. A case history is presented with the characteristic clinical findings in addition to disseminated intravascular coagulation immediately following an amniocentesis to assess fetal lung maturity.

Adult↗
PubMed2000

Amniotic fluid embolism: the UK register.

Amniotic fluid embolism is rare but is a significant cause of maternal death. No clear risk factors seem to be identifiable from previous cases. A register has been established in the UK to look at possible therapies.

Adult↗