Cases reported "Embolism, Amniotic Fluid"

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1/19. amniotic fluid embolism: a case report and review.

    A 41-year old primigravida underwent caesarean section because of foetal distress following prostin induction of labour. Intraoperative coagulopathy, haemorrhage and hypotension necessitated a hysterectomy. Subsequently, she developed respiratory and renal failure, requiring mechanical ventilation and haemodialysis. She made a full recovery. The likely diagnosis was amniotic fluid embolism (AFE), a rare complication of pregnancy with a variable presentation, ranging from cardiac arrest and death through to mild degrees of organ system dysfunction with or without coagulopathy. The differential diagnosis includes pre-eclamptic toxaemia/pregnancy-induced hypertension, anaphylaxis and pulmonary embolism. There is no diagnostic test for AFE; the finding of foetal elements in the maternal circulation is non-specific. Historically, AFE was thought to induce cardiovascular collapse by mechanical obstruction of the pulmonary circulation. It is now thought that a combination of left ventricular dysfunction and acute lung injury occur, with activation of several of the clotting factors. An immunological basis for these effects is postulated. There is no specific therapy and treatment is supportive. The mortality of the condition remains high.
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ranking = 1
keywords = death
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2/19. amniotic fluid embolism.

    pulmonary embolism is the leading cause of maternal death in the united states. amniotic fluid embolism (AFE) represents the least preventable and most lethal of complications with a reported mortality of 86% and an associated fetal demise of 50%. Although it is widely accepted as a clinical entity, AFE is incompletely understood. A combination of clinical presentation, laboratory findings, and exclusion of other pathologies leads to the diagnosis of AFE. The mainstays of treatment are oxygenation, maintenance of cardiac output, and correction of coagulopathy. The prognosis for the patient experiencing AFE remains bleak because it is largely unpredictable and, except for supportive measures, cannot be corrected.
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ranking = 9453.0604050333
keywords = maternal death, death
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3/19. amniotic fluid embolism.

    pulmonary embolism is the leading cause of maternal death in the united states. amniotic fluid embolism (AFE) represents the least preventable and most lethal of complications. AFE has a reported mortality of 86% and an associated fetal demise of 50%. AFE is widely accepted as a clinical entity but is not completely understood. A combination of clinical presentation, laboratory findings, and exclusion of other abnormalities leads to the diagnosis of AFE. The mainstays of treatment are oxygenation, maintenance of cardiac output, and correction of coagulopathy. The prognosis for the patient experiencing AFE remains bleak because the course of the disorder is largely unpredictable, and AFE cannot be corrected. Only supportive measures can be given.
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ranking = 9453.0604050333
keywords = maternal death, death
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4/19. amniotic fluid embolism as cause of death in a car accident--a case report.

    amniotic fluid embolism (AFE), a relatively rare complication in pregnancy, has a high mortality rate. We describe a case of a 38-week pregnant woman with such an embolism leading to almost immediate death after a blunt abdominal trauma inflicted in a motor vehicle accident and probably associated with improper positioning of a seat belt. It has been assumed that the pathophysiology of amniotic fluid embolism is related to an anaphylactoid reaction and that mast cell degranulation indicates this mechanism. Moreover, immunohistochemical antitryptase staining of pulmonary tissue samples in our case revealed mast cell degranulation.
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ranking = 5
keywords = death
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5/19. amniotic fluid embolism.

    amniotic fluid embolism is the most unpredictable and catastrophic complication of pregnancy, accounting for 10% to 20% of maternal deaths. The pulmonary edema commonly seen in this syndrome is probably due primarily to alveolar capillary leakage and may be potentiated by high maternal extracellular volume, low colloid osmotic pressure, and, in some patients, by depressed myocardial function. In patients in whom resuscitation is successful, diuresis leads to rapid resolution of pulmonary edema. amniotic fluid does not ordinarily enter the maternal circulation, and the identification of large numbers of fetal squames in the postpartum pulmonary microvasculature is probably of clinical significance.
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ranking = 9453.0604050333
keywords = maternal death, death
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6/19. Successful pregnancy after amniotic fluid embolism: a case report.

    BACKGROUND: amniotic fluid embolism (AFE) has a mortality rate of 60% to 80% and accounts for approximately 10% of all maternal deaths in the united states. Although AFE is thought to be an anaphylactoid reaction, there are few reports of subsequent pregnancy after AFE. CASE: A healthy 29-year-old underwent an uncomplicated planned Caesarean section for her third pregnancy. She had a history of placental abruption with the first pregnancy and amniotic fluid embolism with the second pregnancy, for which she was treated with blood products and recovered fully. CONCLUSION: This case of a 29-year-old woman with successful subsequent pregnancy after amniotic fluid embolism and a limited number of case reports in the literature suggest that AFE is a sporadic event.
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ranking = 9453.0604050333
keywords = maternal death, death
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7/19. placenta previa and accreta complicated by amniotic fluid embolism.

    BACKGROUND: The simultaneous occurrence of placenta previa and placenta accreta in patients who had previous low transverse cesarean delivery is presently well established. However, the sequence of previous cesarean delivery followed by placenta previa and accreta in a patient who also experiences a premature rupture of membranes as well as amniotic fluid embolism (AFE) is a rare obstetric phenomenon. CASE: A 24-year-old woman, para 2 with two previous cesarean deliveries, at 32 weeks' gestation by last menstrual period, was admitted with premature rupture of membranes. A repeat cesarean delivery (CD) was done. Excessive hemorrhage occurred, necessitating a hysterectomy. Also, the patient developed an amniotic fluid embolism. CONCLUSION: placenta previa and placenta accreta may be observed in patients who have a previous CD scar and in whom AFE develops suddenly and unexpectedly. AFE, a condition with complex pathogenesis, presents a number of challenges, with the patient undergoing serious complications that may include massive hemorrhage, disseminated intravascular coagulopathy, and death. The obstetrician should be alert to the symptoms of AFE, and if they occur should begin prompt and aggressive treatment.
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ranking = 1
keywords = death
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8/19. An unusual occurrence of amniotic fluid embolism.

    amniotic fluid embolism is a rare cause of intrapartum maternal death. Some cases do not fit the typical picture of a multipara in her thirties at or near term. The case presented in this paper involves a 25-year-old gravida 3, para 0, abortion 2, who developed amniotic fluid embolism much earlier in gestation than is usually described.
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ranking = 9453.0604050333
keywords = maternal death, death
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9/19. amniotic fluid embolism. A case report.

    amniotic fluid embolism is a rare, yet catastrophic event. In the united states it occurs in 1 per 20,000 to 30,000 births. With an 86% maternal mortality rate, amniotic fluid embolism is responsible for 10-15% of all maternal deaths. This article presents a case study of a CNM's experience with a maternal and fetal death resulting from an amniotic fluid embolism. Pathogenesis and appropriate management are also presented.
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ranking = 9454.0604050333
keywords = maternal death, death
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10/19. A case of sudden death by decidual cell embolism.

    A 35-year-old multipara died suddenly of a pulmonary embolism about 12 h after delivery. The morphological features and the entry site of the emboli into the circulation suggested that they were decidual cells. Intact decidual cells accounted for only a minority of the emboli: the great majority were cells that had lost their nuclei and/or had been fragmented. The presence of embolized areas, accompanied by fibroblasts and newly formed capillaries, suggested that the embolization process had started before the beginning of labor. However, no symptoms suggesting embolism had been recorded on the clinical chart.
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ranking = 4
keywords = death
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