Amniotic Fluid Embolism

O??Shea, Aidan; Eappen, Sunil

doi:10.1097/aia.0b013e31802b8853

Cited by 40 publications

(29 citation statements)

References 41 publications

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“…129,130 In addition, pulmonary artery catheter guides hemodynamic management and provides direct access for blood samples for monitoring of arterial gases. Transesophageal echocardiography has also been reported to be useful in evaluating cardiac function and guiding fluid therapy.…”

Section: Treatmentmentioning

confidence: 99%

“…Oxygen should be administered immediately by whatever means necessary, including face mask, bag-valve mask, or endotracheal intubation, in concentrations adequate to keep oxygen saturation at 90% or higher. 129,130 Treatment of hypotension includes optimization of preload, with rapid volume infusion of isotonic crystalloid solutions. Fluid therapy should be based on pulmonary artery catheter or transesophageal echocardiography monitoring.…”

Section: Treatmentmentioning

confidence: 99%

“…It is desirable to maintain systolic blood pressure at or higher than 90 mmHg, an arterial PaO 2 of at least 60 mmHg, with acceptable organ perfusion, asindicated by a urinary output of at least 0.5 mL/kg/h or greater than 25 mL/h. 129,130 …”

Section: Treatmentmentioning

confidence: 99%

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Amniotic fluid embolism: an evidence-based review

Conde-Agudelo

Romero

2009

American Journal of Obstetrics and Gynecology

240

277

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We conducted an evidence-based review of information bout amniotic fluid embolism (AFE). The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. The case fatality rate and perinatal mortality associated with AFE are 13–30% and 9–44%, respectively. Risk factors associated with an increased risk of AFE include advanced maternal age, placental abnormalities, operative deliveries, eclampsia, polyhydramnios, cervical lacerations, and uterine rupture. The hemodynamic response in AFE is biphasic, with initial pulmonary hypertension and right ventricular failure, followed by left ventricular failure. Promising therapies include selective pulmonary vasodilators and recombinant activated facto Vlla. Important topics for future research are presented.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Amniotic fluid embolism: an evidence-based review

Conde-Agudelo

Romero

2009

American Journal of Obstetrics and Gynecology

240

277

View full text Add to dashboard Cite

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“…Amniotic fluid helps protect and cushion the fetus and plays an important role in the development of many of the fetal organs including the lungs and kidneys, as well as gastrointestinal tract. Amniotic fluid is produced by the fetal lungs and kidneys, with the largest component being that of urine produced by the fetal kidneys (113)(114)(115)(116)(117)(118)(119)(120)(121)(122)(123). Amniotic fluid problems occur in approximately 7% of all pregnancies with production of excessive or inadequate amounts of amniotic fluid being associated with abnormalities in fetal development and pregnancy complications (124)(125)(126)(127).…”

Section: Introductionmentioning

confidence: 99%

Analysis of Polycyclic Aromatic Hydrocarbons in Amniotic Fluid Samples From Smokers and Nonsmokers

Myers

Zamora

Ali

et al. 2008

Polycyclic Aromatic Compounds

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Previous studies from this laboratory have focused on the characterization of blood protein adducts formed in utero as a result of maternal smoking during pregnancy. These biological samples, obtained during the third trimester of pregnancy, at delivery, have clearly shown a correlation between maternal smoking histories and exposure of the fetus to tobacco smoke carcinogens, including 4-aminobiphenyl and benzo(a)pyrene. In the present study, we examined exposure of the fetus during the first trimester of pregnancy to various environmental carcinogens, particularly those found in tobacco smoke. Amniotic fluid samples were obtained from women undergoing routine amniocentesis between 16 and 20 weeks gestational age. Amniotic fluid, produced by the fetal lungs and kidneys, is an important part of pregnancy and fetal development and this fluid surrounds the fetus throughout pregnancy. In these studies, samples of amniotic fluid were obtained from nonsmokers as well as 0.5 pack per day smokers, 1.0 pack per day smokers, and greater than 2.0 pack per day smokers. Maternal smoking status was determined by questionnaire as well as assessment of amniotic fluid for 39 Downloaded by [University of Kent] at 15:01 07 December 2014 40 S. R. Myers et al. cotinine via immunoassay. Amniotic fluid samples were extracted and analyzed for the presence of polycyclic aromatic hydrocarbons (PAHs). A clear correlation was found between levels of maternal smoking and PAHs in the amniotic fluid.Amniotic fluid 1-hydroxypyrene levels ranged from 1.54 ± 0.12 µg/L in nonsmokers to 11.72 ± 0.67 µg/L in women smoking greater than 2 pks/da, indicating approximately a 10X increase over nonsmokers. Similar results were found 3-hydroxybenzo(a)pyrene, 6-hydroxybenzo(a)pyrene, and 3,6-dihydroxybenzo(a)pyrene, metabolites of the carcinogen benzo(a)pyrene as well as with the 9-hydroxy and 9,10-dihydroxy metabolites of anthracene. The 5-hydroxymethyl metabolite of 5-methylchrysene was found to range in concentrations from 1.65 ± 0.11 µg/L in nonsmokers to 12.67 ± 0.79 µg/L in greater than 2 packs per day smokers.These results demonstrate that amniotic fluid can serve as a biological marker of exposure to tobacco related polycyclic aromatic hydrocarbons. Identification of potentially harmful compounds detected at an early stage of pregnancy may prevent subsequent exposures to the fetus and as a result decrease the risk of potential genotoxic as well as teratogenic events.

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“…The initial presenting signs are often seen on the electrocardiogram and the pulse oximeter. The electrocardiogram may show tachycardia with a right strain pattern and ST-T wave changes, and pulse oximetry may reveal a sudden drop in oxygen saturation (5). Although most patients initially present with cardiac and respiratory failure, there is a subset of patients in whom severe Table 3.…”

Section: Diagnosismentioning

confidence: 99%