Amniotic fluid embolus: Difference between revisions
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===Risk Factors=== | ===Risk Factors=== | ||
*Cesarean delivery | |||
*Advanced maternal age | |||
*Abnormal placental implantation | |||
*Uterine rupture | |||
*[[Eclampsia]] | |||
*Amniocentesis | |||
*Trauma | |||
== | ==Clinical Features== | ||
*Any of the following: | |||
**[[Respiratory distress]] | |||
**[[Pulmonary edema]] | |||
**[[Hypoxia]] | |||
**[[AMS]] | |||
**[[Seizures]] | |||
**Sudden maternal cardiovascular collapse | |||
**[[DIC]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Postpartum emergencies DDX}} | {{Postpartum emergencies DDX}} | ||
==Evaluation== | |||
==Management== | ==Management== | ||
*Treat hypoxia | |||
**NRB or intubate | |||
*Treat hypotension | |||
**[[Pressors]] / [[blood products]] | |||
*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 | |||
==Disposition== | |||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:OBGYN]] | [[Category:OBGYN]] | ||
Revision as of 10:55, 30 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
Clinical Features
- 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
Evaluation
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