Effective Management Of Patients With Amniotic Fluid Embolism In The Intensive Care Unit: Two Case Reports

  • Leonidas Grigorakos National and Kapodistrian University of Athens
  • Nikolaos Markou
  • Daria Lazarescu
  • Katerina Tzortzopoulou
  • Magda Gkouni
  • Eleni Papaioannou
  • Maria Bikou
  • Athanasios Moles

Abstract

Amniotic Fluid Embolism (AFE) is a rare complication of the intra- and early post-partum period, which may also be encountered with cesarean delivery and during abortions. Its symptompatology includes respiratory distress with cyanosis, shock and possibly tonic-clonic seizures. Disseminated intravascular coagulation (DIC) frequently occurs and is usually fatal. The aim of this case report is to present the positive outcome and our gained experience from two cases suffering from AFE. Thus, we analyze the case of two patients, in the second trimester of pregnancy who presented symptoms of AFE. Our study reveals that in the case of patients with AFE, early diagnosis, prompt management and proper treatment increase survival rate and may ensure complete recovery in a relatively short period of time. However, DIC is a serious aggravating factor which makes the recovery process slower.


 

References

1. Conde-Agudelo A., Romero R. Amniotic fluid embolism: An evidence-based review. Am J Obstet Gynecol., 2009, 201(5), 445.e1–445.13. doi:10.1016/j.ajog.2009.04.052.
2. Lewis, G., editor. The seventh report on confidential enquiries into maternal deaths in the United Kingdom. London: CEMACH; 2007. The confidential enquiry into maternal and child health (CEMACH). Saving mother’s lives: reviewing maternal deaths to make motherhood safer -2002– 2005.
3. Thomson AJ, Greer IA. Non-haemorrhagic obstetric shock. Baillieres Best Pract Res Clin Obstet Gynaecol., 2000, 14,19–41.
4. Berg CJ, Callaghan WM, Syverson C, Henderson Z. Pregnancy-related mortality in the United States, 1998 to 2005. Obstet Gynecol, 2010, 116,1302.
5. Abenhaim HA, Azoulay L, Kramer MS, Leduc L. Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Am J Obstet Gynecol., 2008, 199,49.e1–8.
6. Patra AP, Shaha KK, Rayamane AP. Review of 24 cases of Maternal Deaths from Amniotic-Fluid Embolism: in Correlation with Clinical and Histopathological Findings. Sch. Acad. J. Biosci., 2013, 1(3),85-89.
7. Lichtenberg ES and Grimes DA. Surgical Complications: Prevention and Management, in Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care (eds M. Paul, E. S. Lichtenberg, L. Borgatta, D. A. Grimes, P. G. Stubblefield and M. D. Creinin), 2009. Blackwell Publishing Ltd., Oxford, UK. doi: 10.1002/9781444313031.ch15
8. Dean L, Rogers R, Harley R, Hood D. Case Scenario: Amniotic Fluid Embolism. Anesthesiology, 2012, 116, 186-192. doi:10.1097/ALN.0b013e31823d2d99
9. Clark Sl. Amniotic fluid embolism. Clin Perinatol, 1986, 13,801-811.
10. Kaur K, Bhardwaj M, Kumar P, Singhal S, Singh T, Hooda S. Amniotic fluid embolism. J Anaesthesiol Clin Pharmacol., 2016, 32(2), 153–159. doi: 10.4103/0970-9185.173356.
11. Wada H, Matsumoto T, Yamashita Y. Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines. Journal of Intensive Care, 2014, 2,15. DOI: 10.1186/2052-0492-2-15.
12. Strickland MA, Bates GW, Whitworth NS, Martin JN. Amniotic Fluid Embolism: Prophylaxis With Heparin and Aspirin. South. Med. J., 1985, 78 (4), 377-379.
Published
2017-10-12
How to Cite
GRIGORAKOS, Leonidas et al. Effective Management Of Patients With Amniotic Fluid Embolism In The Intensive Care Unit: Two Case Reports. International Archives of Medicine, [S.l.], v. 10, oct. 2017. ISSN 1755-7682. Available at: <http://imedicalsociety.org/ojs/index.php/iam/article/view/2724>. Date accessed: 18 apr. 2019. doi: https://doi.org/10.3823/2527.
Section
Obstetrics & Gynecology