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At least 19 recordsLinked to original sources
PubMed1994

The importance of extensive sampling and examination of cervix in suspected cases of amniotic fluid embolism.

Amniotic fluid embolism is an important complication of pregnancy with high mortality. The diagnosis of amniotic fluid embolism is generally made postmortem and rests upon the histological demonstration of amniotic fluid debris, including foetal epithelial squames and hair, in the pulmonary vasculature. We have made the diagnosis of amniotic fluid embolism in two patients by detection of the amniotic fluid debris in the blood vessels of the cervix in their hysterectomy specimens. These two patients presented with profuse primary postpartum haemorrhage and evidence of disseminated intravascular coagulation after uneventful deliveries. Amniotic fluid debris were only demonstrated in the blood vessels of the cervix but not in the corpus. This observation emphasizes the importance of a thorough histological examination of the cervix in cases of suspected amniotic fluid embolism.

Adult↗
PubMed2002

[Amniotic fluid embolism].

Amniotic fluid embolism is a rare obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enters the maternal circulation. Amniotic fluid embolism is an incompletely understood obstetric complication unique to pregnancy presenting with the acute onset of hypoxia, hypotension and severe coagulopathy. Up to 86% of the cases are fatal, maternal death occurs within the first hour of symptom onset in 50% of the patients. It cannot be predicted nor prevented. The epidemiology of amniotic fluid embolism, frequency, pathophysiology, clinical presentation, histologic findings, diagnosis, differential diagnosis, possible treatment, mortality rate, neonatal survival are discussed in this review article.

Adult↗
PubMed1984

Retinal arteriolar occlusions following amniotic fluid embolism.

Amniotic fluid embolism is a serious complication of pregnancy resulting in death in the majority of patients. Particulate matter originating in the amniotic fluid has been identified at autopsy in the lung, kidney, and brain. A patient is presented who survived amniotic fluid embolism and developed bilateral retinal arteriolar occlusions, presumably based on entrapment of particulate matter originating in amniotic fluid. Her clinical course and ophthalmic findings are reviewed, and the relationship between amniotic fluid embolism and retinal vascular occlusion is discussed.

Adult↗
PubMed1999

Amniotic fluid embolism.

Amniotic fluid embolism occurs rarely but is one of the leading causes of maternal mortality in the United States. The risk of death associated with this syndrome is 60% to 80% with half of survivors suffering long-term neurologic disability. The pathophysiology of amniotic fluid embolism is poorly understood. A review of the largest case series to date concluded that the physiologic and hematologic manifestations bear a greater resemblance to septic and anaphylactic shock than to any embolic phenomenon. Care of the patient who suffers amniotic fluid embolism is supportive. To date, no therapeutic interventions have been found to improve survival.

Animals↗
PubMed2000

Occlusions of branch retinal arterioles following amniotic fluid embolism.

Amniotic fluid embolism is a serious complication of pregnancy with a high mortality. We present a 28-year-old healthy woman who underwent dilatation and curettage for an elective abortion, followed by the sudden loss of vision in her left eye. Occlusion of one branch retinal arteriole was the initial finding of her left fundus, and two occlusions developed consecutively on the color fundus photographs. Fluorescein angiography demonstrated occlusions in three retinal arterioles among seven retinal arterioles originating from the optic disc. These findings suggest that possible mechanisms of amniotic fluid embolism are the unusual cause in retinal arteriolar occlusions. Here clinical course and ophthalmic findings are reviewed, and the relationship between amniotic fluid embolism and retinal arteriolar occlusions is discussed.

Abortion, Legal↗
PubMed1990

An unusual occurrence of amniotic fluid embolism.

Amniotic fluid embolism is a rare cause of intrapartum maternal death. Some cases do not fit the typical picture of a multipara in her thirties at or near term. The case presented in this paper involves a 25-year-old gravida 3, para 0, abortion 2, who developed amniotic fluid embolism much earlier in gestation than is usually described.

Adult↗
PubMed1988

Central hemodynamic alterations in amniotic fluid embolism.

Amniotic fluid embolism is an uncommon but devastating obstetric emergency. We report hemodynamic data derived from pulmonary artery catheterization in four previously unpublished cases of amniotic fluid embolism syndrome. These findings confirm a recently published reinterpretation of the central hemodynamics of this condition.

Blood Pressure↗
PubMed1991

Amniotic fluid embolism.

Amniotic fluid embolism is an almost universally fatal complication of pregnancy. We have presented a case and reviewed the literature concerning this rare but catastrophic problem.

Adult↗
PubMed1991

Amniotic fluid embolism.

Amniotic fluid embolism remains an enigmatic and often lethal condition. The pathophysiology is complex, however, from a clinical standpoint. Right or, more commonly, left heart failure is the dominant physiologic aberration. Disseminated intravascular coagulation is often present. The detection of squamous cells in the central circulation of living patients can no longer be considered pathognomonic for this condition.

Embolism, Amniotic Fluid↗
PubMedDate not supplied

Understanding and management of amniotic fluid embolism.

Amniotic fluid embolism (AFE) is a rare obstetric problem characterized by sudden onset of hypotension, hypoxemia, and coagulopathy. This case represents the difficulty in differentiating AFE from other etiologies of cardiopulmonary compromise. The definitive diagnosis of AFE is made at autopsy with the demonstration of fetal cell elements in the pulmonary vasculature. Diagnosis can be highly suspected if squamous cells and other debris of presumed fetal origin are demonstrated in blood aspirated from the central venous or pulmonary artery circulation of symptomatic parturients. Predisposing factors for AFE include advanced maternal age, multiparity, large fetal size, and short tumultuous labor, especially if uterine stimulants are used. Cardiopulmonary resuscitation is the key to the treatment of parturients with AFE. A pulmonary artery catheter can be helpful in diagnosis and hemodynamic management of parturients with AFE.

Adult↗
PubMed2000

Amniotic fluid embolism.

Amniotic fluid embolism is a rare occurrence, with no single pathognomonic clinical or laboratory finding. Diagnosis is based on clinical presentation and supportive laboratory values. We describe the case of a 17-year-old nulliparous woman at 27 weeks' gestation who had uterine bleeding, hematuria, hemoptysis, hypotension, dyspnea, and hypoxemia within 30 minutes of vaginal delivery. Laboratory values revealed diffuse intravascular coagulation. Chest films were consistent with adult respiratory distress syndrome. Pulmonary artery catheterization revealed moderately increased pulmonary capillary wedge pressure. Supportive measures, including oxygenation, fluid resuscitation, and plasma, were administered. Central hemodynamic monitoring and inotropic support were necessary. Our patient recovered uneventfully and 6 weeks later was living an unrestricted life-style.

Adolescent↗
PubMed1992

Amniotic fluid embolism.

Amniotic fluid embolism is the most unpredictable and catastrophic complication of pregnancy, accounting for 10% to 20% of maternal deaths. The pulmonary edema commonly seen in this syndrome is probably due primarily to alveolar capillary leakage and may be potentiated by high maternal extracellular volume, low colloid osmotic pressure, and, in some patients, by depressed myocardial function. In patients in whom resuscitation is successful, diuresis leads to rapid resolution of pulmonary edema. Amniotic fluid does not ordinarily enter the maternal circulation, and the identification of large numbers of fetal squames in the postpartum pulmonary microvasculature is probably of clinical significance.

Adult↗
PubMed2003

Presumed antepartum amniotic fluid embolism.

BACKGROUND: Amniotic fluid embolism is seldom recognized in nonperipartum patients. The pathophysiology is uncertain and diagnosis imprecise, making management after stabilization difficult. CASE: A 37-year-old woman at 28 weeks' gestation presented with signs and symptoms consistent with amniotic fluid embolism including disseminated intravascular coagulopathy. A ventilation-perfusion scan demonstrated unmatched perfusion defects, but other radiographic studies were negative; the patient was treated with heparin. Four days after presentation she had spontaneous rupture of membranes followed by hypoxemia, necessitating cesarean delivery. A pulmonary arteriogram after the operation showed multiple filling defects; the patient was discharged on warfarin. CONCLUSION: Amniotic fluid embolism is a difficult diagnosis to make, at best. Anticoagulation may be a therapeutic option.

Adult↗
PubMed1989

[Intravascular coagulation in amniotic fluid embolism].

Amniotic embolism (AE) was established in 13 (8.13% out of 160 dead pregnant women and parturients. The morphological examination and clinico-anatomical analysis showed that the degree of obstruction of lung microcirculatory bed was of substantial significance for the course of the disease. Intravascular coagulation (IC) was found in 11 (84.6%) of women with AE. Lungs were damaged by microthrombi most frequently and most severely, which was connected with direct contact activation of blood clotting system by the amniotic fluid. Characteristic peculiarities of AE were their jerk-like course with subclinical period of various duration and early secondary activation of the fibrinolytic system. The morphological sign of the latter was the presence of hyaline globules even within the first hour since the clinical onset of AE. IC and the connected with it acute respiratory insufficiency and consumption coagulopathy were the main thanatogenic factors in AE. This imposed dynamic follow-up of coagulation status and fibrinolytic activity combined with timely anticoagulant and antifibrinolytic treatment.

Adult↗
PubMed2001

Amniotic fluid embolism and isolated coagulopathy: atypical presentation of amniotic fluid embolism.

A 41-year-old multigravida presented at 32 weeks of gestation with polyhydramnios and an anencephalic fetus. Abnormal bleeding as a result of disseminated intravascular coagulation complicated an emergency Caesarean section for severe abdominal pain thought to be due to uterine rupture. Massive transfusion with blood products was necessary and the abdomen packed to control bleeding. The patient was transferred to the intensive care unit where she made a slow but complete recovery. Amniotic fluid embolism with atypical presentation of isolated coagulopathy is the likely diagnosis in this case. The case serves to demonstrate that amniotic fluid embolism may present with symptoms and signs other than the classical pattern of dyspnoea, cyanosis and hypotension.

Adult↗