Amniotic fluid embolism-associated coagulopathy: a single-center observational study.
Amniotic fluid embolism
Critical care
Disseminated intravascular coagulation
Fibrinolysis
Maternal mortality
Pregnancy
Tranexamic acid
Journal
Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
16
12
2019
accepted:
13
02
2020
pubmed:
12
3
2020
medline:
1
9
2020
entrez:
12
3
2020
Statut:
ppublish
Résumé
Amniotic fluid embolism (AFE) continues to be a rare, enigmatic condition with high maternal mortality. It is characterized by cardiovascular compromise, loss of consciousness or other neurologic symptoms, and coagulopathy. The latter is usually treated according to existing protocols for consumptive coagulopathy. Serial analyses of a panel of hemostaseological parameters were performed in three consecutive cases of AFE that occurred at our institution. All mothers and neonates survived without major sequelae. Disproportionately low levels of fibrinogen and factor five, and exorbitantly elevated D-dimers were present in all cases, whereas markers of consumptive coagulopathy, platelets and antithrombin in particular, were only slightly reduced. Our results support hyperfibrinolysis as contributing factor of AFE-associated coagulopathy. We, therefore, propose a treatment algorithm which includes early use of tranexamic acid and transfusion of red blood cells and fresh frozen plasma, adding fibrinogen if hemostasis is not readily achieved.
Identifiants
pubmed: 32157417
doi: 10.1007/s00404-020-05466-w
pii: 10.1007/s00404-020-05466-w
doi:
Substances chimiques
Biomarkers
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
923-929Références
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