Amniotic fluid embolus: Difference between revisions
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*Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae | *Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae | ||
==Risk Factors== | ===Risk Factors=== | ||
#Cesarean delivery | #Cesarean delivery | ||
#Advanced maternal age | #Advanced maternal age | ||
#Abnormal placental implantation | #Abnormal placental implantation | ||
#Uterine rupture | #Uterine rupture | ||
#Eclampsia | #[[Eclampsia]] | ||
==Diagnosis== | ==Diagnosis== | ||
#Any of the following: | #Any of the following: | ||
##Respiratory distress | ##[[Respiratory distress]] | ||
##Pulmonary edema | ##[[Pulmonary edema]] | ||
##Hypoxia | ##[[Hypoxia]] | ||
##AMS | ##[[AMS]] | ||
##Seizures | ##[[Seizures]] | ||
##Sudden maternal cardiovascular collapse | ##Sudden maternal cardiovascular collapse | ||
##DIC | ##[[DIC]] | ||
==Differential Diagnosis== | |||
{{Postpartum emergencies DDX}} | |||
==Management== | ==Management== | ||
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##NRB or intubate | ##NRB or intubate | ||
#Treat hypotension | #Treat hypotension | ||
##Pressors / blood products | ##[[Pressors]] / [[blood products]] | ||
#Avoid hypoperfusion | #Avoid hypoperfusion | ||
##Place pt in left lateral decubitus position | ##Place pt in left lateral decubitus position | ||
#Immediate delivery of fetus: | #Immediate delivery of fetus: | ||
##Perimortem C-section w/in 5min of cardiac arrest if mother cannot be resuscitated | ##[[Perimortem C-section]] w/in 5min of cardiac arrest if mother cannot be resuscitated | ||
==See Also== | ==See Also== | ||
*[[Post-Partum Emergencies]] | *[[Post-Partum Emergencies]] | ||
Revision as of 16:59, 10 January 2015
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
Diagnosis
- 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 pt in left lateral decubitus position
- Immediate delivery of fetus:
- Perimortem C-section w/in 5min of cardiac arrest if mother cannot be resuscitated
See Also
Source
Tintinalli