amniotic fluid embolism
amniotic fluid embolism
A condition resulting from a traumatic delivery and “injection” of amniotic fluid containing lanugo, squames, mucus and debris into the opened maternal circulation, which communicates with the amniotic fluid.Aetiology
Idiopathic; predisposed to by the high intrauterine pressure that allows amniotic fluid to pass into the maternal venous circulation, where the meconium is toxic to the mother, potentially causing DIC.
Clinical findings
Acute shortness of breath, hypertension and rapid progression to cardiac arrest, leading to reduced cardiorespiratory perfusion and coma; those who survive this first phase pass to a haemorrhagic phase, which is characterised by shivering, coughing, vomiting and dysgeusia.
Incidence
1:80,000 deliveries.
Diagnosis
Made on clinical grounds, given the difficulty in identifying squames.
Mortality
26–80%.
IHC
LP34 is a better stain than Cam 5.2 or AE1/AE3, as the latter can stain alveolar epithelial cells.
amniotic fluid embolism
Obstetrics A condition resulting from a traumatic delivery and 'injection' of amniotic fluid containing lanugo, squames, mucus and debris into the opened maternal circulation, which communicates with the amniotic fluid Incidence 1:80,000 deliveries Etiology Idiopathic, predisposed to by the high intrauterine pressure that allows amniotic fluid to pass into the maternal venous circulation, where the meconium is toxic to the mother, potentially causing DIC Mortality ±80%. See Embolism.amniotic fluid embolism
Symptoms
Chest pain, dyspnea, cyanosis, tachycardia, hemorrhage, hypotension, or shock are potential symptoms. Amniotic fluid embolism is frequently fatal.