Title:Epidemiological and Clinical Data of Amniotic Fluid Embolism in Forensic Settings
VOLUME: 14 ISSUE: 14
Author(s):Francesco P. Busardo, Paola Frati, Steven B. Karch and Vittorio Fineschi
Affiliation:Department of Anatomical, Histological, Medico-legal and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336 (00185) Rome, Italy.
Keywords:Amniotic fluid embolism, autopsy and histology, pregnancy related deaths.
Abstract:Amniotic fluid embolism (AFE) is a serious obstetric emergency, burdened with a high rate of mortality and
morbidity and possible permanent neurological sequelae for those women who survive. The clinical presentation commonly
includes: acute hypotension or cardiac arrest, acute hypoxia (dyspnea, cyanosis or respiratory arrest) and coagulopathy
(intravascular coagulation or severe haemorrhage), which usually occur during labour, caesarean section or within
30 minutes of delivery. Some cases for the rapidity of clinical presentation, which can result in fatal outcome, run the risk
of not being recognized, therefore a proper post mortem examination and histological investigation is fundamental in case
of maternal death in order to make the diagnosis and should not be underestimated the incidence of this serious pathological
condition. In this paper, firstly the Authors investigated the fatality rates in AFE patients and its incidence in pregnancy
related deaths, extrapolating epidemiological data regarding the role of this pathology among the leading causes of
maternal mortality. Secondly the contribution of autopsy has been evaluated and further investigation performed on post
mortem in order to confirm or make the diagnosis of AFE to better understand this clinical entity that still remains unclear
under numerous aspects.
