![]() ![]() Amniotic fluid embolism (AFE) is a rare obstetric emergency in which it is postulated that amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, causing cardiorespiratory collapse.Obstetricians should be alert to the symptoms ofĪFE and strive for prompt and aggressive treatment.Patient who has sudden onset of respiratoryĭistress, cardiac collapse, seizures, unexplained Suspect AFE when confronted with any pregnant.Associated with high rates of mortality and.It has a complex pathogenesis and serious.AFE is a sudden and unexpected rare but life.The variance in these numbers is explained by dissimilarĬase definitions and possibly improvements in intensive.Ranging from 26% to as high as 86% have been reported. For women diagnosed as having AFE, mortality rates.Or (3) initial survival with death due to acute respiratoryĭistress syndrome (ARDS) and multiple organ failure Sudden cardiac arrest, (2) hemorrhage due to coagulopathy, Maternal death usually occurs in one of three ways: (1).Ventricular filling pressure may be helpful Indicated monitoring central venous pressure or left Wedge pressure, and BP during infusion prior to infusion,Ĭorrect hypovolemia with either whole blood or plasma, as Precautions: Monitor urine flow, cardiac output, pulmonary. ![]() ![]() Contraindications: ventricular fibrillation, hypovolemia,.DOSE: 2-5 mcg/kg/min IV titrate to BP and cardiac output.Vasculature, increasing renal blood flow and GFR. Dopamine increases myocardial contractility and systolic BP.Mg/dL, and transfuse platelets for platelet counts Treat coagulopathy with FFP for a prolonged aPTT,Ĭryoprecipitate for a fibrinogen level less than 100.Most patients will have hypofibrinogenemia,Ībnormal PT and aPTT and low Platelet counts.The fibrinolytic system is activated as well. DIC results in the depletion of fibrinogen, platelets,Īnd coagulation factors, especially factors V, VIII,Īnd XIII.Nevertheless, these and other frequently cited risk factorsĪre not consistently observed and at the present timeĮxperts agree that this condition is not preventable.Other causes of hemodynamic instability should not be neglected.Īmniotic Fluid Embolism Approach to Management The diagnosis is essentially one of exclusion based on clinical presentation. The diagnosis of AFE has traditionally been made at autopsy when fetal squamous cells are found in the maternal pulmonary circulation however, fetal squamous cells are commonly found in the circulation of laboring patients who do not develop the syndrome. Data from the National Amniotic Fluid Embolus Registry (USA) suggest that the process is more similar to anaphylaxis than to embolism, and the term anaphylactoid syndrome of pregnancy has been suggested because fetal tissue or amniotic fluid components are not universally found in women who present with signs and symptoms attributable to AFE. Steiner and Luschbaugh first described AFE in 1941, after they found fetal debris in the pulmonary circulation of women who died during labor. Amniotic fluid embolism (AFE) is a life threatening obstetric emergency characterized by sudden cardiorespiratory collapse and disseminated intravascular coagulation. ![]()
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