Outcome of pregnancy complicated by amniotic fluid embolus

W. M. Gilbert, Thomas S Nesbitt

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Amniolic fluid enibolus (AFE) is an extremely rate coinplication of prenancv which has been repotted to have a maternal mortalit\ ot ,">0-7,r>%. Prior studies are problematic due to small patient numbers collected over long periods of time. In (his sludv \ve examine all reported cases of AFkl in California in 1992. STUDY DESIGN: I'sing a data set which contains linked records from the birth certificate and ihe hospital discharge record of both mother and babv. all biiths which occurred in acute care civilian hospitals in California in 199t> were analwed. RESULTS: 571.390 patients weie identified who delivered during 1992 including 28 who had the diagnosis of AFK (4.9/1011,000). Of these 28. 3 (lli) iesi:lted in a maternal mortalitv. The mean age (30.8 vr). parih ( >P2, (6;8%), and ccsarean section rate (6-f685) were increased relative to the general population (20.9. ti20, 21.8% respecti\-eh). The average maternal length of si.iv was 8.1 days and mean gestation age at deinerv was 38.4 weeks. AFF. was increased compared 10 the general population in African Americans ( 17.9 v's 7.5%) and Asians ( 17.S vs (1.3 vs 6.3%) and decreased in Hispanics (28.6 vs 44.3%) respeciiveh. Fetal distress was diagnosed in 24% of patients. CONCLUSIONS: (1) In 1992. AFF is not associated with the significant (50-7.")'', ] maternal mortalit\ rate previously reported. (2) While si ill a largely rare and unpredictable event, AFF is associated with certain patient characterisncs including an increase in maternal age. pariu, C 7S rale, and certain rat ial groups (African Americans and I lispanics). One possible explanation toi ihe improvement in pregnancy outcomes demonstrated in our studv is the development of intensive care units with Maternal Fetal Medicine specialists.

Original languageEnglish (US)
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - 1997

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Amniotic Fluid
Pregnancy Outcome
Embolism
Mothers
African Americans
Birth Certificates
Fetal Distress
Hospital Records
Respiratory Sounds
Maternal Age
Hispanic Americans
Population
Intensive Care Units
Medicine
Pregnancy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Outcome of pregnancy complicated by amniotic fluid embolus. / Gilbert, W. M.; Nesbitt, Thomas S.

In: Acta Diabetologica Latina, Vol. 176, No. 1 PART II, 1997.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: Amniolic fluid enibolus (AFE) is an extremely rate coinplication of prenancv which has been repotted to have a maternal mortalit\ ot ,{"}>0-7,r>{\%}. Prior studies are problematic due to small patient numbers collected over long periods of time. In (his sludv \ve examine all reported cases of AFkl in California in 1992. STUDY DESIGN: I'sing a data set which contains linked records from the birth certificate and ihe hospital discharge record of both mother and babv. all biiths which occurred in acute care civilian hospitals in California in 199t> were analwed. RESULTS: 571.390 patients weie identified who delivered during 1992 including 28 who had the diagnosis of AFK (4.9/1011,000). Of these 28. 3 (lli) iesi:lted in a maternal mortalitv. The mean age (30.8 vr). parih ( >P2, (6;8{\%}), and ccsarean section rate (6-f685) were increased relative to the general population (20.9. ti20, 21.8{\%} respecti\-eh). The average maternal length of si.iv was 8.1 days and mean gestation age at deinerv was 38.4 weeks. AFF. was increased compared 10 the general population in African Americans ( 17.9 v's 7.5{\%}) and Asians ( 17.S vs (1.3 vs 6.3{\%}) and decreased in Hispanics (28.6 vs 44.3{\%}) respeciiveh. Fetal distress was diagnosed in 24{\%} of patients. CONCLUSIONS: (1) In 1992. AFF is not associated with the significant (50-7.{"})'', ] maternal mortalit\ rate previously reported. (2) While si ill a largely rare and unpredictable event, AFF is associated with certain patient characterisncs including an increase in maternal age. pariu, C 7S rale, and certain rat ial groups (African Americans and I lispanics). One possible explanation toi ihe improvement in pregnancy outcomes demonstrated in our studv is the development of intensive care units with Maternal Fetal Medicine specialists.",
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