amniotic fluid embolism

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amniotic fluid embolism

Etymology: Gk, amnion; L, fluere, to flow; Gk, embolos, plug
a quantity of amniotic fluid that enters the maternal blood system during labor and/or delivery and becomes lodged in a vessel. It is usually fatal to the mother if it is a pulmonary 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

The entry of amniotic fluid through a tear in the placental membranes into the maternal circulation. This rare event may occur at any gestational age, but most commonly during labor, delivery or in the immediate postpartum period. The contents of the fluid (e.g., shed fetal cells, meconium, lanugo, vernix) may produce pulmonary or cerebral emboli. Cardiac arrest and disseminated intravascular coagulation (DIC) commonly occur. Maternal death is a frequent complication

Symptoms

Chest pain, dyspnea, cyanosis, tachycardia, hemorrhage, hypotension, or shock are potential symptoms. Amniotic fluid embolism is frequently fatal.

See also: embolism