![]() D – Disability: Treat seizures and consider other neurological deficitsĬardiopulmonary resuscitation and immediate caesarean section are required if cardiac arrest occurs. A 32-year-old woman, gravida 3, para 2, at 30 weeks’ gestation is brought to the emergency department because of pain Surgical exploration.C – Circulation: IV fluids to treat hypotension and blood transfusion in haemorrhage.B – Breathing: Provide oxygen for hypoxia.Amniotic fluid embolism is a rare obstetric emergency, estimated to occur in 2 to 6/100,000 pregnancies. She has no significant medical or obstetric history. The initial management of any acutely unwell patient is with an ABCDE approach, assessing and treating: Amniotic fluid embolism is a clinical syndrome of hypoxia, hypotension, and coagulopathy that results from entry of fetal antigens into the maternal circulation. A 32-year-old gravida 4 para 3-0-0-3 is undergoing induction of labor with intravenous (IV) oxytocin at 39 weeks of gestation. Providing progesterone supplementation until 10 weeks would provide adequate time for placenta to take over. Placenta takes over progesterone production around 8-12 weeks. Corpus luteum is responsible for producing progesterone during the first 6-12 weeks of gestation. They are likely to need transfer to the intensive care unit. 9) Progesterone supplementation until 10 weeks’ gestation. It requires the input of experienced obstetricians, medics, anaesthetics, intensive care teams and haematologists. Incidence and risk factors of amniotic fluid embolism: A population-based study on 3 million births in the United States. Abenhaim HA, Azoulay L, Kramer MS, Leduc L. ![]() There are no specific treatments.Īmniotic fluid embolism is a medical emergency – get help immediately. Amniotic-fluid embolism and medical induction of labour: A retrospective, population-based cohort study. 1 2 3 The rate at which it occurs is 1 instance per 20,000. The overall management of amniotic fluid embolism is supportive. An amniotic fluid embolism (AFE) is a very uncommon childbirth ( obstetric) emergency in which amniotic fluid enters the blood stream of the mother, triggering a serious reaction, which results in cardiorespiratory (heart and lung) collapse and massive bleeding ( coagulopathy ). ![]() It can present similarly to sepsis, pulmonary embolism or anaphylaxis, with an acute onset of symptoms of: The main risk factors for amniotic fluid embolus are:Īmniotic fluid embolisation usually presents around the time of labour and delivery, but can be postpartum. This is a rare condition that usually happens during or right after a tough labor and birth. The mortality rate is around 20% or above. Amniotic fluid embolism (AFE), also known as anaphylactoid syndrome of pregnancy, is a pregnancy complication that causes life-threatening conditions, such as heart failure. It has more similarities to anaphylaxis than venous thromboembolism. This immune reaction to cells from the foetus leads to a systemic illness. The amniotic fluid contains fetal tissue, causing an immune reaction from the mother. This usually occurs around labour and delivery. Amniotic fluid embolisation is a rare (2 per 100,000 deliveries) but severe condition where the amniotic fluid passes into the mother’s blood. ![]()
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