pathologyAmnioticfluidand fetal cellsenterthematernal circulation, possibly triggering ananaphylactic reaction to fetal antigens.(1)Clinical symptomsresultfrommast celldegranulation with the release of histamineandtryptase,(2) Clinical symptoms result from activationof the complement pathway
pathology ◼ Amniotic fluid and fetal cells enter the maternal circulation, possibly triggering an anaphylactic reaction to fetal antigens. ◼ (1) Clinical symptoms result from mast cell degranulation with the release of histamine and tryptase, ◼ (2) Clinical symptoms result from activation of the complement pathway
.Progression usuallyoccurs in2phasesphase I:pulmonary artery vasospasm withpulmonary hypertension and elevated rightventricular pressure cause hypoxia.Hypoxia causes myocardial capillarydamage and pulmonary capillary damage,leftheartfailure,and acuterespiratorydistresssyndrome
◼ . Progression usually occurs in 2 phases. ◼ phase I: ◼ pulmonary artery vasospasm with pulmonary hypertension and elevated right ventricular pressure cause hypoxia. ◼ Hypoxia causes myocardial capillary damage and pulmonary capillary damage, left heart failure, and acute respiratory distress syndrome. ◼
Women who survivethese events may enterphase II. This is a hemorrhagic phase characterizedby massive hemorrhage with uterine atonyandDIChowever,fatal consumptive coagulopathymay be the initial presentation
◼ Women who survive these events may enter phase II. ◼ This is a hemorrhagic phase characterized by massive hemorrhage with uterine atony and DIC ◼ however, fatal consumptive coagulopathy may be the initial presentation
PresentationThe clinicalpresentation of AFE isgenerallydramaticin the late stages , acutely dyspnea andhypotension with rapid progression tocardiopulmonaryarrestIn 40% of cases, followed by some degree ofconsumptive coagulopathy
Presentation ◼ The clinical presentation of AFE is generally dramatic ◼ in the late stages , acutely dyspnea and hypotension with rapid progression to cardiopulmonary arrest ◼ In 40% of cases, followed by some degree of consumptive coagulopathy