Title: Amniotic Fluid Embolism: A Nightmare
Authors: Dr Rashmi Bengali, Dr Tushar Patil, Dr Niyati Arora
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.37
Abstract
The disastrous entry of amniotic fluid into the maternal circulation leads to dramatic sequelae of clinical events, characteristically referred to as Amniotic fluid embolism (AFE). AFE can occur during labour, caesarean section, dilatation and evacuation or in the immediate postpartum period where the role of anaesthetist is prudent. The pathophysiology is believed to be immune mediated which affects the respiratory, cardiovascular, neurological and haematological systems. Undetected and untreated, it turns into fulminant pulmonary oedema, intractable convulsions, disseminated intravascular coagulation (DIC), malignant arrhythmias and cardiac arrest. Usually the diagnosis is made clinically however definite diagnosis can be confirmed by identification of lanugo, foetal hair and foetal squamous cells in blood aspirated from the maternal right ventricle. The cornerstone of management is early recognition and aggressive resuscitation with multidisciplinary approach that increases the probability of maternal and neonatal survival.
Keywords: Amniotic fluid embolism, pulmonary oedema, hypoxia, coagulopathy, cardiac arrest
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