Affiliation:
1. Hospital Universitario Severo Ochoa,Department of Anaesthesiology,Madrid,Spain,
2. Hospital Universitario Severo Ochoa,Department of Anaesthesiology,Spain,
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.
Publisher
BENTHAM SCIENCE PUBLISHERS
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