Amniotic fluid embolism - implementation of international diagnosis criteria and subsequent pregnancy recurrence risk.
Adult
Cesarean Section
/ methods
Disseminated Intravascular Coagulation
/ diagnosis
Early Diagnosis
Embolism, Amniotic Fluid
/ diagnosis
Female
Heart Failure
/ diagnosis
Humans
Israel
/ epidemiology
Obstetric Labor Complications
/ diagnosis
Patient Selection
Pregnancy
Pregnancy Outcome
/ epidemiology
Pregnancy Trimesters
Pregnancy, High-Risk
Respiratory Distress Syndrome
/ diagnosis
Retrospective Studies
Vacuum Extraction, Obstetrical
/ methods
amniotic fluid embolism
complications obstetric
diagnostic technique obstetrics and gynecology
embolism
high risk pregnancy
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
25 Jun 2021
25 Jun 2021
Historique:
received:
15
08
2020
accepted:
27
12
2020
pubmed:
21
1
2021
medline:
27
11
2021
entrez:
20
1
2021
Statut:
epublish
Résumé
An international diagnostic criterion for amniotic fluid embolism (AFE) diagnosis has recently been published. Data regarding subsequent pregnancies is scarce. We sought to implement recent diagnostic criteria and detail subsequent pregnancies in survivors. A case series of all suspected AFE cases at a tertiary medical center between 2003 and 2018 is presented. Cases meeting the diagnostic criteria for AFE were included. Clinical presentation, treatment, and outcomes described. Pregnancy outcomes in subsequent pregnancies in AFE survivors detailed. Between 2003 and 2018 14 women were clinically suspected with AFE and 12 of them (85.71%) met the diagnostic criteria for AFE. Three cases occurred during midtrimester dilation and evacuation procedures, and the remaining occurred in the antepartum period. Of the antepartum cases, mode of delivery was cesarean delivery or vacuum extraction for expedited delivery due to presentation of AFE in 8/9 cases (88.88%). Clinical presentation included cardiovascular collapse, respiratory distress and disseminated intravascular coagulopathy (DIC). Heart failure of varying severity was diagnosed in 75% (9/12) cases. Composite maternal morbidity was 5/12 (41.66%), without cases of maternal mortality. 11 subsequent pregnancies occurred in four AFE survivors. Pregnant women were followed by a high-risk pregnancy specialist and multidisciplinary team if pregnancy continued beyond the early second trimester. Six pregnancies resulted in a term delivery. No recurrences of AFE were documented. Use of a diagnostic criterion for diagnosis of AFE results in a more precise diagnosis of AFE. Nevertheless, the accuracy of clinical diagnosis is still high. Subsequent pregnancies were not associated with AFE recurrence.
Identifiants
pubmed: 33470959
doi: 10.1515/jpm-2020-0391
pii: jpm-2020-0391
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
546-552Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 Walter de Gruyter GmbH, Berlin/Boston.
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