Abstract
Purpose: Describe the diagnosis, clinical features, pathophysiology, treatment and anesthetic management of amniotic fluid embolism (AFE) in a patent undergoing second trimester pregnancy termination. Clinical features: A 30-yr-old gravida 2, para 1, woman was admitted for a dilatation and evacuation procedure for underlying intra-uterine fetal demise in her second trimester of pregnancy. Hypotension, shock, respiratory arrest, pulseless electrical activity, hemorrhage, disseminated intravascular coagulopathy, requiring cardiopulmonary resuscitation and blood transfusion complicated her intraoperative care. AFE was considered the most likely cause of this intraoperative event. Conclusions: It is now recognized that the pathophysiological features of AFE are similar to a type-1 hypersensitivity reaction ranging from mild systemic reaction to anaphylaxis and shock. AFE has a high maternal and fetal morbidity and mortality rate, requiring prompt recognition and treatment. In patients with cardiovascular instability, the treatment of AFE is similar to anaphylaxis requiring aggressive fluid hydration, cardiopulmonary resuscitation, administration of blood products and the use of vasopressors.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 139-144 |
| Number of pages | 6 |
| Journal | Canadian Journal of Anesthesia |
| Volume | 51 |
| Issue number | 2 |
| State | Published - Feb 2004 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Amniotic fluid embolism with second trimester pregnancy termination : A case report. / Ray, Barry K.; Vallejo, Manuel C.; Creinin, Mitchell D; Shannon, Kelly T.; Mandell, Gordon L.; Kaul, Bupesh; Ramanathan, Sivan.
In: Canadian Journal of Anesthesia, Vol. 51, No. 2, 02.2004, p. 139-144.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Amniotic fluid embolism with second trimester pregnancy termination
T2 - A case report
AU - Ray, Barry K.
AU - Vallejo, Manuel C.
AU - Creinin, Mitchell D
AU - Shannon, Kelly T.
AU - Mandell, Gordon L.
AU - Kaul, Bupesh
AU - Ramanathan, Sivan
PY - 2004/2
Y1 - 2004/2
N2 - Purpose: Describe the diagnosis, clinical features, pathophysiology, treatment and anesthetic management of amniotic fluid embolism (AFE) in a patent undergoing second trimester pregnancy termination. Clinical features: A 30-yr-old gravida 2, para 1, woman was admitted for a dilatation and evacuation procedure for underlying intra-uterine fetal demise in her second trimester of pregnancy. Hypotension, shock, respiratory arrest, pulseless electrical activity, hemorrhage, disseminated intravascular coagulopathy, requiring cardiopulmonary resuscitation and blood transfusion complicated her intraoperative care. AFE was considered the most likely cause of this intraoperative event. Conclusions: It is now recognized that the pathophysiological features of AFE are similar to a type-1 hypersensitivity reaction ranging from mild systemic reaction to anaphylaxis and shock. AFE has a high maternal and fetal morbidity and mortality rate, requiring prompt recognition and treatment. In patients with cardiovascular instability, the treatment of AFE is similar to anaphylaxis requiring aggressive fluid hydration, cardiopulmonary resuscitation, administration of blood products and the use of vasopressors.
AB - Purpose: Describe the diagnosis, clinical features, pathophysiology, treatment and anesthetic management of amniotic fluid embolism (AFE) in a patent undergoing second trimester pregnancy termination. Clinical features: A 30-yr-old gravida 2, para 1, woman was admitted for a dilatation and evacuation procedure for underlying intra-uterine fetal demise in her second trimester of pregnancy. Hypotension, shock, respiratory arrest, pulseless electrical activity, hemorrhage, disseminated intravascular coagulopathy, requiring cardiopulmonary resuscitation and blood transfusion complicated her intraoperative care. AFE was considered the most likely cause of this intraoperative event. Conclusions: It is now recognized that the pathophysiological features of AFE are similar to a type-1 hypersensitivity reaction ranging from mild systemic reaction to anaphylaxis and shock. AFE has a high maternal and fetal morbidity and mortality rate, requiring prompt recognition and treatment. In patients with cardiovascular instability, the treatment of AFE is similar to anaphylaxis requiring aggressive fluid hydration, cardiopulmonary resuscitation, administration of blood products and the use of vasopressors.
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UR - http://www.scopus.com/inward/citedby.url?scp=1842840147&partnerID=8YFLogxK
M3 - Article
C2 - 14766690
AN - SCOPUS:1842840147
VL - 51
SP - 139
EP - 144
JO - Canadian Journal of Anaesthesia
JF - Canadian Journal of Anaesthesia
SN - 0832-610X
IS - 2
ER -