This is a 38year old pregnant woman with amniotic sac ruptured, cervix with 5cm dilation, complaining of severe pain. Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Afe develops after a relatively large amount of amniotic. Owing to its uncertain etiology, varying symptoms, rapid onset, and high fatality rate, amniotic fluid embolism afe is one of the most. Summary amniotic fluid embolism afe, although an uncommon obstetric disorder, has a high case fatality rate and remains a leading cause.
Amniotic fluid embolism causing catastrophic pulmonary vasoconstriction. Principles of early clinical management article pdf available in american journal of obstetrics and gynecology 2221 july 2019 with 233 reads how we measure reads. Excessive fluid administration should be avoided grade 1c. A period of anxiety, change in mental status, agitation, and a sensation of doom may precede the event. Amniotic fluid embolism afe is a rare and typically catastrophic condition that occurs when amniotic fluid enters the maternal circulation. Ddx in any women with sudden cardiovascular collapse or cardiac arrest seizures, severe respiratory difficulty or hypoxia, particularly if such events are followed by a coagulopathy that cannot be otherwise explained ddx long. Amniotic fluid embolism afe is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the. Amniotic fluid embolism is a condition that occurs because there is systemic reaction similar to that found in an allergic response to amniotic fluid or fetal cells or fetal tissue debris by the pregnant mother. Society for maternalfetal medicine smfm with the assistance of luis d. Amniotic fluid embolism gynecology and obstetrics msd manual. The reported incidence of afe varies because of a wide spectrum of presenting signs and symptoms, as well as lack of a standardized approach to diagnostic evaluation of patients with suspected afe.
Amniotic fluid embolism, cardiovascular collapse, dic, disseminated. Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%. Aok a novel treatment for amniotic fluid embolism sukhdeep rathore bsn, rn, ccrn yekaterina shchapina bsn, rn, ccrn university of pennsylvania dnpna class of 2020. Let us be careful not to make the diagnosis of amniotic fluid embolism a waste basket for cases of unexplained death during labor. Amniotic fluid embolism is a rare but serious condition that occurs when amniotic fluid the fluid that surrounds a baby in the uterus during pregnancy or fetal material, such as fetal cells, enters the mothers bloodstream. Amniotic fluid embolism afe is a rare and often fatal obstetric condition, characterized by sudden. Amniotic fluid embolism during vaginal delivery under analgesia. The clinical presentation of amniotic fluid embolism is, in its classic form, dramatic.
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