Historical Perspective of Amniotic Fluid Embolism

Kane, Sean

doi:10.1097/01.aia.0000182634.01573.e5

Cited by 7 publications

(14 citation statements)

References 38 publications

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“…[4][5][6]16,17 To achieve this there are certain goals of treatment. To maintain tissue oxygenation, 100% supplemental oxygen is indicated with intubation and ventilation to maintain positive end respiratory pressure and attempt to achieve a level of PaO 2 60 mmHg with the saturation above 90%.…”

Section: Managementmentioning

confidence: 99%

“…[4][5][6]13,17,19 For circulatory support the Advanced Cardiac Life Support [ACLS] protocol should be initiated with the mother in the left lateral decubitus position. 4,13,16 Colloids and crystalloids should be administered with inotropes such as dopamine, dobutamine or phenylephrine. The aim is to improve the circulation and maintain a urine output of more than 25 ml/hour with the mean arterial pressure above 65 mmHg.…”

Section: Managementmentioning

confidence: 99%

“…The aim is to improve the circulation and maintain a urine output of more than 25 ml/hour with the mean arterial pressure above 65 mmHg. 12, 13,16 The b-adrenergic effects of dopamine, epinephrine and norepinephrine improve cardiac function in addition to the a-adrenergic effect of phenylephrine. 4,12 Other treatment modalities include nitric oxide (a selective pulmonary vasodilator), cardiopulmonary bypass, extracorporeal membrane oxygenation and intra-aortic balloon counter pulsation.…”

Section: Managementmentioning

confidence: 99%

“…4,12 Other treatment modalities include nitric oxide (a selective pulmonary vasodilator), cardiopulmonary bypass, extracorporeal membrane oxygenation and intra-aortic balloon counter pulsation. 4,9,12,16 Delivery of the foetus improves the survival of the foetus and helps with the maternal cardiopulmonary resuscitation. 4,16,17,19 Intact foetal survival is possible if the foetus is delivered within 5 minutes.…”

Section: Managementmentioning

confidence: 99%

“…4,9,12,16 Delivery of the foetus improves the survival of the foetus and helps with the maternal cardiopulmonary resuscitation. 4,16,17,19 Intact foetal survival is possible if the foetus is delivered within 5 minutes. Improvement in maternal outcome is possible if the foetus is delivered within 4 minutes of developing malignant arrhythmia via a perimortem caesarean section.…”

Section: Managementmentioning

confidence: 99%

See 4 more Smart Citations

Managing acute collapse in pregnant women

Lombaard

Soma-Pillay

Farrell

2009

Best Practice & Research Clinical Obstetrics & Gynaecol

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Keywords:acute collapse pulmonary embolism amniotic fluid embolism acute coronary syndrome mechanical prosthetic heart valves acute aortic dissection cerebrovascular incidents and anaesthetic complications failed intubation anaphylaxisThe most important causes of acute collapse in pregnancy are pulmonary embolism, amniotic fluid embolism, acute coronary syndrome, thrombosed mechanical prosthetic heart valves, acute aortic dissection, cerebrovascular incidents and anaesthetic complications like failed intubation, anaphylaxis, and problems relating to regional or local anaesthetic agents. The management is based on supporting the different organ systems that are affected. The diagnosis of pulmonary embolism is based on a clinical suspicion supported by certain diagnostic test. Tests like D-dimers have their limitations and cannot be used alone to exclude the diagnosis especially when there is a high clinical suspicion. The choice of the best diagnostic tool is based upon weighing longterm risks to both mother and foetus on the one side and delaying the diagnosis on the other side. The management of acute coronary syndrome is based on immediate angiography and percutaneous coronary intervention. Although there are reports of the use of clopidrogel in pregnancy, there are few data on its effect on the foetus. There is no clinical evidence for fibrinolytic therapy as a reperfusion strategy in pregnancy and it is best avoided as the risk of haemorrhage outweighs the possible benefit of treatment. Patients with a prosthetic heart valve that present with a disappearance of the prosthetic heart sounds or a new murmur should get an urgent cardiac ultrasound to rule out a thrombosed prosthetic valve. Anaesthesia-related causes are an increasing cause of maternal morbidity and mortality.

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

See 3 more Smart Citations

Managing acute collapse in pregnant women

Lombaard

Soma-Pillay

Farrell

2009

Best Practice & Research Clinical Obstetrics & Gynaecol

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Evaluation of specific marker CK13 and CK10/13 combined with APM staining for the diagnosis of amniotic fluid embolism and aspiration

Wang

Lai

Pan

et al. 2014

Forensic Science International

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Amniotic fluid embolism: Still a diagnostic enigma for obstetrician and pathologist?

Turillazzi

Greco

Neri

et al. 2009

Acta Obstet Gynecol Scand

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Eight fatal cases of amniotic fluid embolism (AFE) are described to identify definable and preventable risk factors increasing the incidence of AFE. Maternal age, past medical history, previous pregnancies and outcome, prenatal care, gestational age, neonatal outcome, mode of delivery, time of the onset of clinical symptoms, and maternal autopsy findings were retrospectively analyzed. Risk factors and clinical manifestations present in the patients were investigated. Peripartum clinical information included tachycardia and shock as the most frequent symptoms (62.5%), while bradycardia and coma were present in 37.5% of the victims. The interval between onset of labor and symptoms ranged between 0.4 and 7.5 hours. All the women died within seven hours of the onset of the symptoms. AFE can neither be predicted nor prevented as cases occur sporadically with a broad spectrum of clinical manifestations that are less consistent than that previously reported.

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Historical Perspective of Amniotic Fluid Embolism

Cited by 7 publications

References 38 publications

Managing acute collapse in pregnant women

Managing acute collapse in pregnant women

Evaluation of specific marker CK13 and CK10/13 combined with APM staining for the diagnosis of amniotic fluid embolism and aspiration

Amniotic fluid embolism: Still a diagnostic enigma for obstetrician and pathologist?

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