Recent Advances in Anesthesiology

Volume: 4

Air and Amniotic Fluid Embolism

Author(s): Clara Isabel Fernandez Sánchez*, Adriana Carolina Orozco Vinasco, Monica San Juan Alvarez and Marta Chacón Castillo

Pp: 258-267 (10)

DOI: 10.2174/9789815051841122040017

* (Excluding Mailing and Handling)

Abstract

Amniotic fluid embolism (AFE) is an uncommon pathology, whose incidence ranges from 2 to 8 per 100,000 births, depending on the country. This syndrome has four cardinal symptoms: circulatory collapse, respiratory distress, cyanosis and coma. If the patient survives cardiorespiratory failure, disseminated intravascular coagulopathy occurs, leading to incoercible bleeding and eventually death. Clinical diagnosis is based on Clark's four criteria: sudden cardiorespiratory arrest, established disseminated intravascular coagulation prior to bleeding, and all of these occurring peripartum in the absence of fever. The two main differential diagnosis syndromes are pulmonary thromboembolism and myocardial infarction. Treatment consists of cardiopulmonary support of the patient. Despite aggressive measures, such as the placement of ventricular assist devices and external oxygenation membranes, the prognosis continues to be poor. The main death cause is incoercible bleeding caused by disseminated intravascular coagulopathy.


Keywords: Amniotic Fluid Embolism, Cardiopulmonary Arrest, Coma, Cyanosis, Death, Disseminated Intravascular Coagulopathy, Embolism, Extracorporeal Membrane Oxygenation, Myocardial Infarction, Postpartum Hemorrhage, Pulmonary Embolism, Respiratory Distress Syndrome, Ventricular Assist Devices.

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