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PubMed2006

[Amniotic fluid embolism: two case reports].

We report two cases of amniotic fluid embolism, confirmed by histological examination. Both patients had an immediate post-partum haemorrhage that required an haemostatic hysterectomy. A typical symptomatology of amniotic fluid embolism revelated the first case. The patient survived without any sequelae. In the second case, amniotic fluid embolism occurred immediately after the delivery. The patient developed an acute respiratory distress with a shock syndrome. Despite haemostatic hysterectomy and resuscitative efforts, she died 6 days later.

Adult↗
PubMed1992

Successful cardiopulmonary resuscitation of a parturient with amniotic fluid embolism.

A case of presumed amniotic fluid embolism is presented. Diagnosis is based on clinical findings in a 21-year-old parturient, who was admitted to hospital at 39 weeks gestation. During labor the patient became dyspneic and cyanotic, had convulsions and finally suffered a cardiac arrest. During cardiopulmonary resuscitation she was placed in a left semilateral position and an emergency cesarean section was performed immediately. Following delivery of the baby the heart rhythm returned to normal. The prolonged resuscitation produced serious neurological sequelae in both mother and infant in the first few months following delivery, though with complete long-term recovery. This case report highlights the importance of displacing the uterus laterally and performing an emergency cesarean section during resuscitation.

Journal Article↗
PubMed1997

[The value of blood sedimentation test in early diagnosis of amniotic fluid embolism].

OBJECTIVE: To explore the value of peripheral blood sedimentation in early diagnosis of amniotic fluid embolism. METHOD: The contents of amniotic fluid were detected with blood sedimentation test in 15 cases of amniotic fluid embolism and 100 cases of normal pregnant women. RESULTS: The contents of amniotic fluid including particles of vernix caseasa, lanugo hair and epithelium cells were found in serum of amniotic fluid embolism cases but not found in cases of normal pregnant women. CONCLUSION: It suggested that the blood sedimentation test would be valuable for early diagnosis of amniotic fluid embolism.

Adult↗
PubMed1976

Amniotic fluid embolism with survival.

Well-documented amniotic fluid embolism with survival is an uncommon occurrence. A case is reported with characteristic clinical findings in addition to electrocardiographic evidence of acute right heart strain, disseminated intravascular coagulation, and amniotic fluid debris in central venous blood. The impact of this complication on maternal mortality is emphasized. Aggressive therapy with attention to the basic principles of supportive care offers the best chance of survival.

Adult↗
PubMed1998

Expression of endothelin-1 in amniotic fluid embolism and possible pathophysiological mechanism.

Since endothelin is a potent vasoconstrictor and bronchoconstrictor, endothelin-1 expression in the lung was investigated using immunohistological techniques in two cases of amniotic fluid embolism. Intense expression of endothelin-1 was observed in amniotic squames while weaker staining was seen in alveolar epithelium, bronchiolar epithelium and intraalveolar macrophages and focally in vascular endothelium. Endothelin-1 may play a role in the early and transient haemodynamic alteration of pulmonary hypertension in amniotic fluid embolism.

Embolism, Amniotic Fluid↗
PubMed2003

Non-fatal amniotic fluid embolism after cervical suture removal.

We describe a case of pulmonary oedema occurring at 37 weeks gestation, following the attempted removal of a cervical suture under general anaesthesia. The use of an ultrasound technique to demonstrate the patient's fluid status is described. Signs of amniotic fluid embolism and how it exerts its influence on the circulation are discussed.

Adult↗
PubMed1977

[Clinical aspects of amniotic fluid embolism].

An analysis of 456 cases of amniotic fluid embolism of the literature is given. It is reported about age of women, parity, duration of pregnancy, complications in delivery, period of time to death, weight of children and their mortality. Two own cases are reported. A discussion of symptoms, different diagnosis, treatment and the possibility of prophylaxis is included.

Adult↗
PubMed1995

[Analysis of 29 maternal deaths caused by amniotic fluid embolism].

Twenty nine maternal deaths caused by amniotic fluid embolism (AFE) during 1989-1993 in Beijing area were reviewed. The results show that the average maternal mortality ratio due to AFE was 5.9/100,000 live births responsible for 15.5% of total maternal deaths. In 13 of the 29 patients presented the clinical signs were of postpartum hemorrhage and coagulation disorders. Oxytocics had been used in 12 of the 29 cases during labor. In more than half of the patients there was delay in diagnosis. This was that the percentage of AFE which may present with the signs of coagulation disorder was higher than previously thought, and unreasonable use of oxytocics during labor may be associated with AFE. This kind of AFE is easy to misdiagnose.

Adult↗
PubMed1992

Successful pregnancy outcomes after amniotic fluid embolism.

Two patients who survived cardiorespiratory arrest occurring in association with amniotic fluid embolism syndrome were seen during the subsequent pregnancy. Both had uneventful pregnancies and delivered at term without complications. These are the only case reports of pregnancy after amniotic fluid embolism, and they support a model of amniotic fluid embolism involving chemically abnormal amniotic fluid rather than an unusual sensitivity to normal amniotic fluid.

Adult↗
PubMed1993

Delayed onset of coagulopathy following amniotic fluid embolism: two case reports.

Two cases of amniotic fluid embolism with markedly similar clinical presentations occurred in the same unit in a 6 month period. Both patients were under general anaesthesia for caesarean section at the time of embolism. Having been successfully extubated and found to be haemodynamically stable, they developed a coagulopathy after an interval of 2 hours. There had been initial uncertainty as to the diagnosis in the first patient and the haematological sequelae were not fully anticipated. Experience in dealing with the first patient who died, may have influenced the survival of the second. The diagnosis of amniotic fluid embolism should be considered at an early stage in all cases of maternal collapse and the appropriate preparations made to combat a potential coagulopathy.

Journal Article↗
PubMed2006

Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study.

BACKGROUND: Amniotic-fluid embolism is a rare, but serious and often fatal maternal complication of delivery, of which the cause is unknown. We undertook an epidemiological study to investigate the association between amniotic-fluid embolism and medical induction of labour. METHODS: We used a population-based cohort of 3 million hospital deliveries in Canada between 1991 and 2002 to assess the associations between overall and fatal rates of amniotic-fluid embolism and medical and surgical induction, maternal age, fetal presentation, mode of delivery, and pregnancy and labour complications. FINDINGS: Total rate of amniotic-fluid embolism was 14.8 per 100,000 multiple-birth deliveries and 6.0 per 100,000 singleton deliveries (odds ratio 2.5 [95% CI 0.9-6.2]). Of the 180 cases of amniotic-fluid embolism in women with singleton deliveries during the study period, 24 (13%) were fatal. We saw no significant temporal increase in occurrence of amniotic-fluid embolism for total or fatal cases. Medical induction of labour nearly doubled the risk of overall cases of amniotic-fluid embolism (adjusted odds ratio 1.8 [1.3-2.7]), and the association was stronger for fatal cases (crude odds ratio 3.5 [1.5-8.4]). Maternal age of 35 years or older, caesarean or instrumental vaginal delivery, polyhydramnios, cervical laceration or uterine rupture, placenta previa or abruption, eclampsia, and fetal distress were also associated with an increased risk. INTERPRETATION: Medical induction of labour seems to increase the risk of amniotic-fluid embolism. Although the absolute excess risk is low, women and physicians should be aware of this risk when making decisions about elective labour induction.

Adult↗
PubMed2000

Successful application of extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation as lifesaving therapy for a patient with amniotic fluid embolism.

A woman in labor was noted to have amniotic fluid embolism. Extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation were performed post partum, and the vital signs became stable. The ensuing recovery was uneventful. We conclude that extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation should be considered to save the life of a patient with amniotic fluid embolism and left ventricular failure unresponsive to medical therapy.

Adult↗