Amniotic fluid embolism. Report of four cases at Hospital Universitario La Paz, in Madrid, Spain, and review of the literature
DOI:
https://doi.org/10.18597/rcog.131Keywords:
Embolism, amniotic fluid, heart arrest, disseminated intravascular coagulation, infant mortalityAbstract
Introduction: Amniotic fluid embolism (AFE) is an infrequent condition considered unpredictable and unpreventable, and it is associated with high maternal morbidity and mortality. Early diagnosis is critical in order to improve prognosis. The objective of this case report is to review the diagnosis, treatment and main discussion points found in the literature regarding this disease condition.
Material and methods: We report 4 cases of AFE presenting over a period of 10 years to the Hospital Universitario La Paz, in Madrid, Spain, a high complexity center of the national health system. One of the cases is reported in detail because it is the most representative of the disease presentation in terms of the clinical characteristics and the time sequence of symptom onset. A search was conducted in English and Spanish in Medline via Pub Med for the last 10 years, using the terms amniotic fluid embolism, cardiac arrest, disseminated intravascular coagulation, neonatal mortality. The search included case series, cohort studies, cases and controls, and review articles.
Results: Of a total of 150 titles found, 26 were included: 10 case series, 5 cohort studies and 11 reviews. The diagnosis is based on clinical criteria and early treatment is focused on cardiorespiratory and hemodynamic support.
Conclusion: Adequate knowledge of AFE is required in order to suspect the diagnosis and guide therapeutic management in these patients as adequately and promptly as possible.
Author Biographies
Rocío Revello-Álvarez
Daniel Abehsera-Davó
Mariana Panal-Cusati
José Luis Bartha-Rasero
References
Conde-Agudelo A, Romero R. Amniotic fluid embolism: an evidence based review. Am J Obstet Gynecol 2009;201:445.e1-13.
Clark SL, Hankins GD, Dudley DA, Dildy GA, Porter TF. Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol 1995;172:1158-67.
Clark SL, Montz FJ, Phelan JP. Hemodynamic alterations associated with amniotic fluid embolism: a reappraisal. Am J Obstet Gynecol 1985;151:617-21.
Clark SL. New concepts of amniotic fluid embolism: a review. Obstet Gynecol Surv 1990;45:360-8.
Gilbert WM, Danielsen B. Amniotic fluid embolism: decreased mortality in a population-based study. Obstet Gynecol 1999;93:973-7.
Abenhaim HA, Azoulay L, Kramer MS, Leduc L. Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Am J Obstet Gynecol 2008;199:49. e1-8.
Knight M, Berg C, Brocklehurst P, Kramer M, Lewis G, Oats J, et al. Amniotic fluid embolism incidence, risk factors and outcomes: a review and recommendations. BMC Pregnancy Childbirth 2012;10:12-7.
Kramer MS, Rouleau J, Baskett TF, Joseph KS. Maternal Health Study Group of the Canadian Perinatal Sur veillance System. Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study. Lancet 2006;368:1444-8.
Mulder JI. Amniotic fluid embolism: an overview and case report. Am J Obstet Gynecol 1985;152:430-5.
Lee W, Ginsburg KA, Cotton DB, Kaufman RH. Squamous and trophoblastic cells in the maternal pulmonar y circulation identified by invasive hemodynamic monitoring during the peripartum period. Am J Obstet Gynecol 1986;155:999-1001.
Clark SL, Pavlova Z, Greenspoon J, Horenstein J, Phelan JP. Squamous cells in the maternal pulmonary circulation. Am J Obstet Gynecol 1986;154:104-6.
Giampaolo C, Schneider V, Kowalski BH, Bellaver LA. The cytologic diagnosis of amniotic fluid embolism: a critical reappraisal. Diagn Cytopathol 1987;3:126-8.
Kanayama N, Yamazaki T, Naruse H, Sumimoto K, Horiuchi K, Terao T. Determining zinc coproporphyrin in maternal plasma—a new method for diagnosing amniotic fluid embolism. Clin Chem 1992;38:526-9.
Benson MD, Kobayashi H, Silver RK, Oi H, Greenberger PA, Terao T. Immunologic studies in presumed amniotic fluid embolism. Obstet Gynecol 2001;97:510-4.
Oi H, Kobayashi H, Hirashima Y, Yamazaki T, Kobayashi T, Terao T. Serological and immunohistochemical diagnosis of amniotic fluid embolism. Semin Thromb Hemost 1998;24:479-84.
Rufforny-Doudenko I, Sipp C, Shehata BM. Pathologic quiz case. A 30-year-old woman with severe disseminated intravascular coagulation during delivery. Arch Pathol Lab Med 2002;126:869-70.
McDonnell NJ, Chan BO, Frengley RW. Rapid reversal of critical haemodynamic compromise with nitric oxide in a parturient with amniotic fluid embolism. Int J Obstet Anesth 2007;16:269-73.
van Heerden PV, Webb SA, Hee G, Corkeron M, Thompson WR. Inhaled aerosolized prostacyclin as a selective pulmonary vasodilator for the treatment of severe hypoxaemia. Anaesth Intensive Care 1996;24:87-90.
Prosper SC, Goudge CS, Lupo VR. Recombinant factor VIIa to successfully manage disseminated intravascular coagulation from amniotic fluid embolism. Obstet Gynecol 2007;109:524-5.
Lim Y, Loo CC, Chia V, Fun W. Recombinant factor VIIa after amniotic fluid embolism and disseminated intravascular coagulopathy. Int J Gynaecol Obstet 2004;87:178-9.
Knight M, UKOSS. Amniotic fluid embolism: active surveillance versus retrospective database review. Am J Obstet Gynecol 2008;199:e9.44.
Clark S. Amniotic fluid embolism. Clin Obstet and Gynecol 2010;53:322-328.
Clark SL. Successful pregnancy outcomes after amniotic fluid embolism. Am J Obstet Gynecol 1992;167:511-2.
Duffy BL. Does amniotic fluid embolism recur? Anaesth Intensive Care 1998;26:333.
Collier C. Recurring amniotic fluid embolism. Anaesth Intensive Care 1998;26:599-600.
Stiller RJ, Siddiqui D, Laifer SA, Tiakowski RL, Whetham JC. Successful pregnancy after suspected anaphylactoid syndrome of pregnancy (amniotic fluid embolus). A case report. J Reprod Med 2000;45:1007-9.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
