AMNIOTIC FLUID EMBOLISM

Posted by e-Medical PPT Tuesday, August 17, 2010
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.
Overall incidence ranges from 1 in 8,000 to 1 in 80,000 pregnancies. 10% of maternal deaths in USA and 16% in UK.75 % of survivors are expected to have long-term neurologic deficits.If the fetus is alive at the time of the event, nearly 70 % will survive the delivery but 50% of the survived neonates will incur neurologic damage.
The pathophysiology of Amniotic fluid embolism is poorly understood.It is believed however that once the fluid and fetal cells enter the maternal pulmonary circulation in general terms there will be profound respiratory failure with deep cyanosis and cardiovascular shock followed by convulsions and profound coma.Cotton (1996), has proposed a biphasic model.
  • First phase - The patient experiences acute shortness of breath and hypotension. This rapidly progresses to cardiac arrest.
  • Second phase -Hemorrhagic phase characterized by massive hemorrhage and uterine atony.
The similar homodynamic derangements seen with AFE syndrome , anaphylactic, and septic shock have led investigators to postulate a substance in amniotic fluid resulting in the release of primary and secondary endogenous mediators (i.e. arachidonic acid metabolites) which might also be responsible for the associated coagulopathy in AFE.

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1 Response to AMNIOTIC FLUID EMBOLISM

  1. Anonymous Says:
  2. Interesting read.thanks 4 the post.

     

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