Amniotic fluid embolus: Difference between revisions
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Revision as of 18:33, 21 July 2016
Background
- Diagnosis of exclusion
- Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae
Risk Factors
- Cesarean delivery
- Advanced maternal age
- Abnormal placental implantation
- Uterine rupture
- Eclampsia
- Amniocentesis
- Trauma
Evaluation
- Any of the following:
- Respiratory distress
- Pulmonary edema
- Hypoxia
- AMS
- Seizures
- Sudden maternal cardiovascular collapse
- DIC
Differential Diagnosis
3rd Trimester/Postpartum Emergencies
- Acute fatty liver of pregnancy
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- HELLP syndrome
- Mastitis
- Peripartum cardiomyopathy
- Postpartum endometritis (postpartum PID)
- Postpartum headache
- Postpartum hemorrhage
- Preeclampsia
- Resuscitative hysterotomy
- Retained products of conception
- Septic abortion
- Uterine rupture
Management
- Treat hypoxia
- NRB or intubate
- Treat hypotension
- Avoid hypoperfusion
- Place patient in left lateral decubitus position
- Immediate delivery of fetus:
- Perimortem C-section within 5min of cardiac arrest if mother cannot be resuscitated