Amniotic Fluid Embolism(AFE)羊水栓塞
Amniotic Fluid Embolism (AFE) 羊水栓塞
Definition of AFEAFE is a rare obstetric emergency in whichamnioticfluid,fetal cells,hair,or otherdebris enter the maternalcirculation,causing cardiorespiratorycollapse
Definition of AFE ◼ AFE is a rare obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, causing cardiorespiratory collapse
epidemiologyThe incidence of clinically detectable AFE is lowestimatedtobe1in 20,000to 80,000live births.Maternal mortality approaches 80%.5%-10%of maternal mortality in theUnited StatesisduetoAFEOf patientswithAFE,50%die withinthefirsthourof onset of symptoms.Of survivors of the initial cardiorespiratory phase,50% develop a coagulopathyNeonatal survivalis70%
epidemiology ◼ The incidence of clinically detectable AFE is low ◼ estimated to be 1 in 20,000 to 80,000 live births. ◼ Maternal mortality approaches 80%. ◼ 5%- 10% of maternal mortality in the United States is due to AFE. ◼ Of patients with AFE, 50% die within the first hour of onset of symptoms. ◼ Of survivors of the initial cardiorespiratory phase, 50% develop a coagulopathy. ◼ Neonatal survival is 70%
Current data suggest that the process ismore similar to anaphylaxis than toembolismterm anaphylactoid syndrome of pregnancyhasbeensuggested
◼ Current data suggest that the process is more similar to anaphylaxis than to embolism ◼ term anaphylactoid syndrome of pregnancy has been suggested
Major causes and factorsoccurs in obstetric terms or during labormultiparous woman with a large babya short tumultuous laboruse of uterine stimulantsoccurred during abortionamnioinfusionAmniocentesiscaesarian sectionplacenta accretaruptured uterus
Major causes and factors ◼ occurs in obstetric terms or during labor ◼ multiparous woman with a large baby ◼ a short tumultuous labor ◼ use of uterine stimulants ◼ occurred during abortion ◼ amnioinfusion ◼ Amniocentesis ◼ caesarian section ◼ placenta accreta ◼ ruptured uterus