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Amniotic fluid embolic

Yi Mu, Nolan McDonnell, Zhuoyang Li, Juan Liang, Yanping Wang, Jun Zhu, Elizabeth Sullivan
BACKGROUND: To analyse the maternal mortality ratio, demographic and pregnancy related details in women who suffered a fatal amniotic fluid embolism (AFE) in China. METHODS: A retrospective population based study using data collected as part of the National Maternal Mortality Surveillance System between 1996 and 2013. Data were collected onto a standardised form from women whose cause of death was listed as being secondary to AFE. RESULTS: Records were available for 640 deaths...
October 19, 2016: BMC Pregnancy and Childbirth
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
Eric M Wise, Ricky Harika, Fatima Zahir
Amniotic fluid embolism (AFE) is a rare, catastrophic emergency that requires prompt recognition and treatment. Despite early recognition and supportive therapy, the morbidity and mortality remain high. We report a case of AFE after vacuum-assisted vaginal delivery resulting in hemodynamic collapse and subsequent multiorgan failure. Management included mechanical ventilation, extracorporeal membrane oxygenation, and continuous veno-venous hemodialysis. The patient was able to make a full recovery with minimal sequelae...
November 2016: Journal of Clinical Anesthesia
Akihiro Hasegawa, Takeshi Murakoshi, Yoshiro Otsuki, Yuichi Torii
Amniotic fluid embolism (AFE) is a rare complication of pregnancy and its mortality rate is high. There have been few reports of AFE with presence of severe coagulopathy and incoagulable bleeding, and absence of cardiopulmonary symptoms or limited cardiopulmonary symptoms, followed by massive blood loss during delivery. Such cases have been referred to as disseminated intravascular coagulopathy-type AFE, and the characteristics of this condition have been presented previously. Here we report three cases that fulfilled the diagnostic characteristics of disseminated intravascular coagulopathy-type AFE...
September 20, 2016: Journal of Obstetrics and Gynaecology Research
Karl Kristensen, Fali Langdana, Howard Clentworth, Chu Hansby, Paul Dalley
We present a case of the successful treatment of severe amniotic fluid embolism in a 41-year-old woman undergoing emergency caesarean section at 36 weeks of gestation for placental abruption and intrauterine fetal demise. The treatment included prolonged cardiopulmonary resuscitation, emergency hysterectomy, re-operation with intra-abdominal packing and intra-aortic balloon pump insertion. The patient made a remarkable recovery and to date has minimal residual morbidity. Amniotic fluid embolism syndrome (AFES) is a rare and often fatal obstetric condition that remains one of the main causes of maternal mortality in developed countries...
2016: New Zealand Medical Journal
Peter M Hession, Cynthia J Millward, Joyce E Gottesfeld, Thomas F Rehring, Kevin B Miller, Paul M Chetham, S Kel Muckleroy, Christopher A Bates, Harris W Hollis
Amniotic fluid embolism (AFE) is a catastrophic consequence of labor and delivery that often results in maternal and neonatal death. These poor outcomes are related largely to the rarity of the event in a population overwhelmingly biased by overall good health. Despite the presence of national AFE registries, there are no published algorithmic approaches to its management, to our knowledge. The purpose of this article is to share a care pathway developed by a multidisciplinary group at a community teaching hospital...
August 17, 2016: Permanente Journal
S Cutts, R Talboys, C Paspula, E M Prempeh, R Fanous, D Ail
Adult respiratory distress syndrome (ARDS) has now been described as a sequela to such diverse conditions as burns, amniotic fluid embolism, acute pancreatitis, trauma, sepsis and damage as a result of elective surgery in general. Patients with ARDS require immediate intubation, with the average patient now being ventilated for between 8 and 11 days. While the acute management of ARDS is conducted by the critical care team, almost any surgical patient can be affected by the condition and we believe that it is important that a broader spectrum of hospital doctors gain an understanding of the nature of the pathology and its current treatment...
August 11, 2016: Annals of the Royal College of Surgeons of England
Stephen E Lapinsky
Respiratory failure affects up to 0.2% of pregnancies, more commonly in the postpartum period. Altered maternal respiratory physiology affects the assessment and management of these patients. Respiratory failure may result from pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism or peripartum cardiomyopathy. Pregnancy may increase the risk or severity of other conditions, including thromboembolism, asthma, viral pneumonitis, and gastric acid aspiration. Management during pregnancy is similar to the nonpregnant patient...
September 2015: Obstetric Medicine
A Rafael, M D Benson
BACKGROUND: The first case report to describe amniotic fluid embolism that appeared in 1926 in Basil-Medico is translated from Portuguese to English. CASE: A patient with a dead fetus for several weeks, presented in labor and died suddenly with fetal squames evident in the maternal pulmonary vasculature at autopsy. CONCLUSION: As can be seen from the translation, this case report is remarkably similar in many of its features to some of the eight patients described 15 years later in the first English language discussion of the disease by Steiner and Luschbaugh in JAMA...
March 2014: Obstetric Medicine
Michael D Benson
Amniotic fluid embolism was first recognized in 1926, in a Brazilian journal case report, on the basis of large amounts of fetal material in the maternal pulmonary vasculature at autopsy. The first English language description appeared in 1941 and consisted of eight parturients dying suddenly in which, once again, fetal material was seen in the pulmonary vasculature. A control group of 34 pregnant women dying of other recognized causes did not have fetal material in their lungs. The incidence of recognized, serious illness is on the order of two to eight per 100,000, with a mortality rate ranging from 13% to 35%...
March 2014: Obstetric Medicine
Lucia Aurini, Maria P Rainaldi, Paul F White, Battista Borghi
No abstract text is available yet for this article.
July 21, 2016: Minerva Anestesiologica
Steven L Clark, Roberto Romero, Gary A Dildy, William M Callaghan, Richard M Smiley, Arthur W Bracey, Gary D Hankins, Mary E D'Alton, Mike Foley, Luis D Pacheco, Rakesh B Vadhera, J Patrick Herlihy, Richard L Berkowitz, Michael A Belfort
Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic fluid embolism is often overdiagnosed in critically ill peripartum women, particularly when an element of coagulopathy is involved. Previously proposed case definitions for amniotic fluid embolism are nonspecific, and when viewed through the eyes of individuals with experience in critical care obstetrics, would include women with a number of medical conditions much more common than amniotic fluid embolism...
October 2016: American Journal of Obstetrics and Gynecology
Agnieszka Helena Koziołek, Michał Gaca, Krzysztof Szymanowski Szymanowski, Elżbieta Ziętek-Bartlewicz
Amniotic fluid embolism is a rare and diagnostically challenging obstetric disease of high mortality rate. We present a case of a 33-year old parturient after vaginal birth, who presented with severe hemorrhagic shock with low platelet count and coagulopathy resistant to treatment with plasma, platelets and coagulation factors and despite of surgical management of bleeding. Laboratory findings revealed consumptive coagulopathy. Other symptoms included dyspnea and atelectatic changes on chest x-ray, together with augmentation of the heart with no proof of ventricular insufficiency in echocardiographic examination...
2016: Ginekologia Polska
Naduthottam Palaniswami Kamalesh, Kurumboor Prakash, Ganesh Narayanan Ramesh
Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and effective method of providing nutrition to patients with neurologic deficits or proximal gastrointestinal pathology. Complications that follow this common procedure include dislodgement, dysfunction, infection, gastric/colonic perforation, bleeding, peritonitis, or death. The emergency physician should be aware of the complications and symptoms/signs associated for appropriate management of these patients. We present a case of a young lady who developed a cerebral infarction following amniotic fluid embolism during her cesarean section and had undergone a PEG tube placement...
April 2016: Indian Journal of Surgery
Lior Drukker, Hen Y Sela, Alexander Ioscovich, Arnon Samueloff, Sorina Grisaru-Granovsky
Amniotic fluid embolism occurring following diagnostic amniocentesis is extremely rare. Only 2 cases have been reported in the English literature over the past 55 years, the most recent one approximately 3 decades ago. We present a case of amniocentesis at 24 weeks' gestation that was performed as part of an evaluation of abnormal fetal ultrasound findings. Immediately following amniotic fluid aspiration, maternal hemodynamic collapse occurred, initially diagnosed and treated as anaphylactic shock. Shortly after initial therapy, coagulopathy was noted and amniotic fluid syndrome suspected...
June 9, 2016: Fetal Diagnosis and Therapy
Kiranpreet Kaur, Mamta Bhardwaj, Prashant Kumar, Suresh Singhal, Tarandeep Singh, Sarla Hooda
Amniotic fluid embolism (AFE) is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse. Etiology largely remains unknown, but may occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the second trimester of pregnancy. It may also occur up to 48 hours post-delivery. It can also occur during abortion, after abdominal trauma, and during amnio-infusion...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Pervez Sultan, Katherine Seligman, Brendan Carvalho
PURPOSE OF REVIEW: This article reviews our current understanding of amniotic fluid embolism (AFE), specifically the pathogenesis, treatment strategies, potential diagnostic tests and future therapeutic interventions for AFE. RECENT FINDINGS: The incidence and case mortality of AFE varies widely because of heterogeneous diagnostic criteria and varying reporting mechanisms across the world. Amniotic fluid embolism is thought to be caused by abnormal activation of immunologic mechanisms following entry of fetal antigens into maternal circulation...
June 2016: Current Opinion in Anaesthesiology
Junichi Hasegawa, Akihiko Sekizawa, Hiroaki Tanaka, Shinji Katsuragi, Kazuhiro Osato, Takeshi Murakoshi, Masahiko Nakata, Masamitsu Nakamura, Jun Yoshimatsu, Tomohito Sadahiro, Naohiro Kanayama, Isamu Ishiwata, Katsuyuki Kinoshita, Tomoaki Ikeda
OBJECTIVE: To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems. DESIGN: Descriptive study. SETTING: Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG). PARTICIPANTS: Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213)...
2016: BMJ Open
Luis D Pacheco, George Saade, Gary D V Hankins, Steven L Clark
OBJECTIVE: We sought to provide evidence-based guidelines regarding the diagnosis and management of amniotic fluid embolism. STUDY DESIGN: A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through March 2015. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted...
August 2016: American Journal of Obstetrics and Gynecology
Koichi Yoneyama, Atsuko Sekiguchi, Takashi Matsushima, Rieko Kawase, Akihito Nakai, Hirobumi Asakura, Toshiyuki Takeshita
AIM: The aim of the present study was to elucidate the clinical characteristics of pregnancy-associated maternal deaths. METHODS: We performed a retrospective analysis with medical records and autopsy reports of cases of pregnancy-associated deaths. We collected information on all maternal deaths related to pregnancy that occurred in 3 hospitals affiliated with Nippon Medical School in Japan from January 1, 1984, to December 31, 2014. Data analyzed were maternal age, past medical history, parity, gestational age, clinical signs and symptoms, cause of death, and maternal autopsy findings...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
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