1/8. amniotic fluid embolism.amniotic fluid embolism is a rare occurrence, with no single pathognomonic clinical or laboratory finding. diagnosis is based on clinical presentation and supportive laboratory values. We describe the case of a 17-year-old nulliparous woman at 27 weeks' gestation who had uterine bleeding, hematuria, hemoptysis, hypotension, dyspnea, and hypoxemia within 30 minutes of vaginal delivery. Laboratory values revealed diffuse intravascular coagulation. Chest films were consistent with adult respiratory distress syndrome. pulmonary artery catheterization revealed moderately increased pulmonary capillary wedge pressure. Supportive measures, including oxygenation, fluid resuscitation, and plasma, were administered. Central hemodynamic monitoring and inotropic support were necessary. Our patient recovered uneventfully and 6 weeks later was living an unrestricted life-style.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/8. Understanding and management of amniotic fluid embolism.amniotic fluid embolism (AFE) is a rare obstetric problem characterized by sudden onset of hypotension, hypoxemia, and coagulopathy. This case represents the difficulty in differentiating AFE from other etiologies of cardiopulmonary compromise. The definitive diagnosis of AFE is made at autopsy with the demonstration of fetal cell elements in the pulmonary vasculature. diagnosis can be highly suspected if squamous cells and other debris of presumed fetal origin are demonstrated in blood aspirated from the central venous or pulmonary artery circulation of symptomatic parturients. Predisposing factors for AFE include advanced maternal age, multiparity, large fetal size, and short tumultuous labor, especially if uterine stimulants are used. cardiopulmonary resuscitation is the key to the treatment of parturients with AFE. A pulmonary artery catheter can be helpful in diagnosis and hemodynamic management of parturients with AFE.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
3/8. Transient left heart failure in amniotic fluid embolism.We report a patient with amniotic fluid embolism (AFE) in whom the occurrence of late onset, severe pulmonary oedema was due to isolated left ventricular (LV) failure. Following institution of diuretics and inotropic support, the situation promptly improved and follow-up haemodynamic assessment showed complete recovery of LV function. This report indicates that reversible LV failure may occur late after AFE and emphasises the usefulness of pulmonary artery catheterisation for proper assessment and guidance of therapy of pulmonary oedema in AFE.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
4/8. Successful treatment of postpartum shock caused by amniotic fluid embolism with cardiopulmonary bypass and pulmonary artery thromboembolectomy.We report the successful treatment of a moribund patient as a result of amniotic fluid embolism with cardiopulmonary bypass and open pulmonary artery thromboembolectomy. review of the literature indicates that this is the first reported case of treatment of amniotic fluid embolism with cardiopulmonary bypass and pulmonary thromboembolectomy.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
5/8. Hemodynamic alterations associated with amniotic fluid embolism: a reappraisal.Experimental amniotic fluid embolism in animals produces profound pulmonary hypertension and acute cor pulmonale without evidence of left ventricular compromise. Authors reporting hemodynamic alterations associated with clinical amniotic fluid embolism have traditionally attempted to explain their findings within this experimental framework. A reanalysis of the five published cases of amniotic fluid embolism, which include hemodynamic data derived from pulmonary artery catheterization as well as a report of a sixth case suggests a hemodynamic interpretation different from the traditional one based on the animal model. Left ventricular failure is the only hemodynamic abnormality consistently observed in humans, and the published data are most readily explained on this basis alone. A theoretical model of hemodynamic changes accompanying amniotic fluid embolism that incorporates both experimental and clinical observations is presented. Therapeutic implications are discussed.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
6/8. Rapid diagnosis of amniotic fluid embolism.Acute respiratory failure developed in a 19-year-old primigravida 7 hours after undergoing cesarean section. The diagnosis of amniotic fluid embolism was established by viewing fragments of vernix caseosa in a pulmonary artery blood sample. Forty-eight hours after the cytologic diagnosis had been made, amniotic fluid material was no longer present in pulmonary arterial blood. The patient underwent supportive care in an intensive care setting and recovered completely.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
7/8. amniotic fluid embolism: a case with non-cardiogenic pulmonary edema.We report an uncommon case of amniotic fluid embolism (AFE) in a 24-year-old woman with a 26th-week, second pregnancy. Clinical manifestations were dominated by acute respiratory distress and pulmonary edema. Recovery was complete. Early invasive hemodynamic studies showed normal function of the left ventricle with a low pulmonary artery occluded pressure. These findings are controversial to the concept of cardiogenic pulmonary edema in AFE.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
8/8. amniotic fluid embolus.A case report of a 27-yr-old healthy patient for Caesarean section under epidural anaesthesia is presented. The patient suffered an acute cardiorespiratory collapse when the infant's head was being delivered through the anterior abdominal wall. The patient remained cyanosed after proper tracheal intubation and pulmonary ventilation with 100% O2. hypotension was difficult to treat but returned to normal 25 min after the event. A pulmonary artery catheter inserted three hours after the event showed normal pressures and a high cardiac output. The patient suffered permanent neurological damage. The differential diagnosis is discussed and current concepts of the aetiology and management of amniotic fluid embolism reviewed.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |