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 Release 24.0, April 2009
 
Chapter : ch15. Obstetics & Gynecology Section : Maternal Assessment During Pregnancy
  Risk Factors for Amniotic Fluid Embolism

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Overview :

Amniotic fluid embolism can be a devastating syndrome with disseminated intravascular coagulation, respiratory failure, circulatory collapse and sudden death. Prompt recognition and aggressive therapy can be lifesaving.

 

Risk factors for amniotic fluid embolism:

(1) older age

(2) multiparity

(3) intense uterine contractions, either physiologic or drug induced

(4) abdominal trauma

(5) cesarean section

(6) uterine rupture

(7) high cervical tear

(8) premature placental separation

(9) placental abruption

(10) intrauterine fetal demise or fetal distress

 

Most cases (80%) occur during labor, but it can occur either before labor or after delivery. About 25% of patients will die within 1 hour of onset.

 

The diagnosis of amniotic fluid embolism should be considered when a pregnant woman with one or more of these risk factors suddenly deteriorates with respiratory distress, bleeding or shock.

 

  References:

Bick RL. Disseminated intravascular coagulation: A review of etiology. pathophysiology, diagnosis and management: Guidelines for care. Clin Appl Thrombosis/Hemostasis. 2002; 8: 1-31 (Table 3, page 3).

 

 

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