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amniotic fluid embolism

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https://www.readbyqxmd.com/read/28817205/amniotic-fluid-embolism-mortality-rate
#1
Michael D Benson
AIM: The objective of this study was to determine the mortality rate of amniotic fluid embolism (AFE) using population-based studies and case series. METHODS: A literature search was conducted using the two key words: 'amniotic fluid embolism (AFE)' AND 'mortality rate'. Thirteen population-based studies were evaluated, as well as 36 case series including at least two patients. RESULTS: The mortality rate from population-based studies varied from 11% to 44%...
August 17, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28755459/defining-definitions-a-delphi-study-to-develop-a-core-outcome-set-for-conditions-of-severe-maternal-morbidity
#2
T Schaap, K Bloemenkamp, C Deneux-Tharaux, M Knight, J Langhoff-Roos, E Sullivan, T van den Akker
OBJECTIVE: Develop a core outcome set of international consensus definitions for severe maternal morbidities. DESIGN: Electronic Delphi study. SETTING: International. POPULATION: Eight expert panels. METHODS: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions...
July 29, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#3
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#4
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#5
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28612901/assessing-malpractice-lawsuits-for-death-or-injuries-due-to-amniotic-fluid-embolism
#6
S Zaami, E Marinelli, G Montanari Vergallo
Amniotic fluid embolism (AFE) is a pregnancy complication known to be extremely hard to diagnose, since it manifests itself abruptly and with no warning signs, presenting an incidence rate of about 1 in 40000 deliveries, and maternal morbidity and mortality ranging from 20% to 60%. Although almost a century has gone by since it was first identified (1926) and despite medical research having been conducted on such a syndrome, diagnostic procedures and treatment methods have not yet been clarified enough. Specific biochemical markers have been produced in research laboratories, but their clinical value results to be limited, given how rapid the pathological process moves forward...
May 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#7
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28561251/management-of-acute-respiratory-failure-in-pregnancy
#8
Stephen E Lapinsky
Respiratory failure affects up to 1 in 500 pregnancies, more commonly in the postpartum period. The causes of respiratory failure include several pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism, and peripartum cardiomyopathy. Pregnancy may also increase the risk or severity of other conditions, such as asthma, thromboembolism, viral pneumonitis, and gastric acid aspiration. Changes to maternal respiratory physiology and the presence of a fetus may affect the assessment and management of these patients...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28558024/maternal-age-and-severe-maternal-morbidity-a-population-based-retrospective-cohort-study
#9
Sarka Lisonkova, Jayson Potts, Giulia M Muraca, Neda Razaz, Yasser Sabr, Wee-Shian Chan, Michael S Kramer
BACKGROUND: One of the United Nations' Millennium Development Goals of 2000 was to reduce maternal mortality by 75% in 15 y; however, this challenge was not met by many industrialized countries. As average maternal age continues to rise in these countries, associated potentially life-threatening severe maternal morbidity has been understudied. Our primary objective was to examine the associations between maternal age and severe maternal morbidities. The secondary objective was to compare these associations with those for adverse fetal/infant outcomes...
May 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28464190/amniotic-fluid-embolism-is-a-new-pregnancy-possible-case-report
#10
Ana Filipa Cabrita Caeiro, Irina Dulce Tapadinhas Matos Ramilo, Ana Paula Santos, Elizabeth Ferreira, Isabel Santos Batalha
Amniotic fluid embolism (AFE) is a rare but potentially catastrophic clinical condition, characterized by a combination of signs and symptoms that reflect respiratory distress, cardiovascular collapse and disseminated intravascular coagulation (DIC). Its pathogenesis is still unclear. More recently, the traditional view of obstruction of pulmonary capillary vessels by amniotic fluid emboli as the main explanation for the etiology has been ruled out, and immunologic factors and the activation of the inflammatory cascade took on an important role...
July 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28460634/acute-kidney-injury-during-pregnancy-and-puerperium-a-retrospective-study-in-a-single-center
#11
Chunhong Huang, Shanying Chen
BACKGROUND: Acute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates. OBJECTIVE: The aim of this study was to investigate the incidence, characteristics, and outcomes of AKI during pregnancy and puerperium in a Chinese population. METHODS: In this study, pregnant women discharged from hospital between January 2008 and June 2015 were screened. AKI was defined if the level of serum creatitine >70...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28383386/what-is-new-in-amniotic-fluid-embolism-best-articles-from-the-past-year
#12
REVIEW
Michael D Benson
This month, we focus on current research in amniotic fluid embolism. Dr. Benson discusses four recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts.
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28329897/maternal-labor-delivery-and-perinatal-outcomes-associated-with-placental-abruption-a-systematic-review
#13
Katheryne L Downes, Katherine L Grantz, Edmond D Shenassa
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption...
August 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28302245/amniotic-fluid-embolism
#14
Tayyab Mohyuddin, Shahbaz Sarwar, Dawar Ayyaz
We report a case of 34-year patient who had uncomplicated elective caesarean-section. Postoperatively, she developed sudden hypotension, bradycardia, dyspnea and disseminated intravascular coagulation (DIC), all signs associated with amniotic fluid embolism (AFE). Echocardiogram showed signs of acutely increased right ventricular after load including McConell's sign, i.e. right ventricular dilatation, segmental hypokinesia (mid-right ventricular) and hypercontractile right ventricular apex and overall right ventricular dysfunction...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28282766/risk-factors-for-fatality-in-amniotic-fluid-embolism-a-systematic-review-and-analysis-of-a-data-pool
#15
Ugo Indraccolo, Caterina Battistoni, Irene Mastrantonio, Romolo Di Iorio, Pantaleo Greco, Salvatore Renato Indraccolo
PURPOSE: Investigating risk factors for amniotic fluid embolism (AFE)-induced fatality. METHODS: A systematic review of cases of AFE available on PubMed, Scielo, Scopus and AJOL databases that occurred from 1990 to 2015 was carried out. After careful reading of titles, abstracts and full texts, case reports of AFE were reviewed. Risk factors for AFE were considered as independent variables in logistic regression models. The first model was built on the whole data pool...
March 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28262236/disseminated-intravascular-coagulation-in-pregnancy-clinical-phenotypes-and-diagnostic-scores
#16
Offer Erez
During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28252305/-analysis-of-maternal-morbidity-and-mortality-in-slovak-republic-in-the-years-2007-2012
#17
M Korbeľ, A Krištúfková, M Dugátová, J Daniš, B Némethová, P Kaščák, Z Nižňanská
OBJECTIVE: Analysis of maternal morbidity and mortality in Slovak Republic (SR) in the years 2007-2012. DESIGN: Epidemiological perinatological nation-wide. SETTINGS: 1st Department of Gynaecology and Obstetrics School of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: The analysis of selected maternal morbidity and mortality data prospective collected in the years 2007-2012 from all obstetrics hospitals in the Slovak Republic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28236427/procoagulant-extracellular-vesicles-in-amniotic-fluid
#18
Lena Hell, Lukas Wisgrill, Cihan Ay, Andreas Spittler, Michael Schwameis, Bernd Jilma, Ingrid Pabinger, Peter Altevogt, Johannes Thaler
Embolization of amniotic fluid (AF) into the blood circulation leads to disseminated intravascular coagulation (DIC). Procoagulant phosphatidylserine (PS)- and tissue factor (TF)-exposing extracellular vesicles (EVs) might play an important role in AF embolism-induced DIC. It was the aim of the present study to perform analyses of the procoagulant properties of AF with a panel of functional coagulation assays and flow cytometry. We applied a prothrombinase assay (that quantifies PS exposure on EVs), an EV-associated TF activity assay, a fibrin generation assay, a thrombin generation assay, a whole blood clotting model, and flow cytometry in AF and control plasma...
February 4, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28192732/reproductive-decisions-after-the-diagnosis-of-amniotic-fluid-embolism
#19
Amirhossein Moaddab, Miranda Klassen, Cynthia D Priester, Elvira H Munoz, Michael A Belfort, Steven L Clark, Gary A Dildy
OBJECTIVE: This study aims to describe the subsequent reproductive outcomes in women who either correctly or incorrectly were diagnosed with amniotic fluid embolism (AFE). STUDY DESIGN: Medical records were obtained, abstracted and reviewed by authors with extensive experience in critical care obstetrics. Telephone interviews of all survivors were conducted to determine obstetrical and contraceptive history. A subgroup underwent further telephone interview to address subsequent reproductive decisions...
April 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28188959/amniotic-fluid-embolism-pathophysiology-from-the-perspective-of-pathology
#20
REVIEW
Naoaki Tamura, Mustari Farhana, Tomoaki Oda, Hiroaki Itoh, Naohiro Kanayama
Amniotic fluid embolism (AFE) is recognized as a type of syndrome characterized by the abrupt onset of hypoxia, hypotension, seizures, or disseminated intravascular coagulopathy (DIC), occurring during labor, delivery, or immediately postpartum, caused by the inflow of amniotic components into the maternal circulation. AFE is a rare condition but one of the most serious obstetrical complications, resulting in a high mortality rate among pregnant women. Despite earlier recognition and intensive critical management, we often encounter patients who unfortunately do not recover from the exacerbation of AFE-related conditions...
April 2017: Journal of Obstetrics and Gynaecology Research
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