Survival after an amniotic fluid embolism following the use of sodium bicarbonate. Massive amniotic fluid embolism: diagnosis aided by emergency transesophageal echocardiography. Amniotic fluid embolism: an interdisciplinary challenge: epidemiology, diagnosis and treatment. James CF, Feinglass NG, Menke DM, Grinton SF, Papadimos TJ. Case 33-2019: A 35-Year-Old Woman with Cardiopulmonary Arrest during Cesarean Section. Providing progesterone supplementation until 10 weeks would provide adequate time for placenta to take over. Placenta takes over progesterone production around 8-12 weeks. Corpus luteum is responsible for producing progesterone during the first 6-12 weeks of gestation. Kramer MS, Rouleau J, Baskett TF, Joseph KS, Maternal Health Study Group of the Canadian Perinatal Surveillance System Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study. 9) Progesterone supplementation until 10 weeks’ gestation. Amniotic fluid embolism: analysis of the national registry. 2015 May 28(7):793-8.Ĭlark SL, Hankins GD, Dudley DA, Dildy GA, Porter TF. The most up to date UK data states that there is an incidence of 2/100,000 pregnancies. It is often a fatal complication of pregnancy and the puerperium, and is a direct cause of maternal death. Amniotic fluid embolism: antepartum, intrapartum and demographic factors. Amniotic fluid embolism (AFE) is a recognised, yet rare cause of maternal collapse. Other causes of hemodynamic instability should be ruled out.Ĭopyright © 2023, StatPearls Publishing LLC.įong A, Chau CT, Pan D, Ogunyemi DA. The diagnosis is of exclusion based on clinical presentation. The diagnosis of AFE has been established at autopsy when fetal squamous cells are found in the maternal pulmonary artery blood however, fetal squamous cells are also sometimes present in the circulation of laboring women who do not develop AFE. Data from the National Amniotic Fluid Embolism Registry suggests that the process resembles anaphylaxis more than embolism, and the terminology of "anaphylactoid syndrome of pregnancy" has been recommended because fetal tissue or amniotic fluid components are not always found in women who present with signs and symptoms attributable to amniotic fluid embolism. Steiner and Luschbaugh first described amniotic fluid embolism in 1941, after they found fetal cells in the maternal pulmonary circulation, who died during labor. In the United States, AFE occurs in 2 to 8 per 100,000 deliveries and is the cause of maternal mortality between 7.5% to 10%. Survivors are frequently left with serious cardiac, renal, neurologic, and pulmonary dysfunction. The presentation is abrupt, usually with sudden cardiorespiratory collapse followed by severe coagulopathy and refractory resuscitation. Amniotic fluid embolism (AFE) represents the second leading cause of peripartum maternal death in the United States and the number one cause of peripartum cardiac arrest. Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency characterized by sudden cardiorespiratory collapse and disseminated intravascular coagulation.
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