![]() Findings In this cohort study of 14.6 million deliveries in the National Inpatient Sample from 2016 to 2019, the incidence of AFE was 6.0 per 100 000 deliveries, and placental accreta spectrum was associated with a 10-times increased risk of AFE. Maternal treatment is primarily supportive, whereas prompt delivery of the mother who has sustained cardiopulmonary arrest is critical for improved newborn outcome. Question What pregnancy characteristics and maternal outcomes are associated with amniotic fluid embolism (AFE). Data regarding the presence of risk factors for amniotic fluid embolism are inconsistent and contradictory at present, no putative risk factor has been identified that would justify modification of standard obstetric practice to reduce the risk of this condition. We present a case of cardiac arrest secondary to presumed AFE and the use of atropine-ondansetron-ketorolac (AOK). No well-studied protocols are available for management of AFE. ![]() ![]() Clinical series based on population or administrative databases that do not include individual chart review by individuals with expertise in critical care obstetrics are likely to both overestimate the incidence and underestimate the mortality of this condition by the inclusion of women who did not have amniotic fluid embolism. Article Figures & Data References Info & Metrics PDF Abstract Background: Amniotic fluid embolism (AFE) is a rare cause of severe maternal morbidity and mortality. Progress in our understanding of this syndrome continues to be hampered by a lack of universally acknowledged diagnostic criteria, the clinical similarities of this condition to other types of acute critical maternal illness, and the presence of a broad spectrum of disease severity. Current recommended treatment for AFE includes pulmonary vasodilators, prostaglandins, sympathomimetics, and a host of other interventions 5, 10, 15, 21. The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. This response and its subsequent injury appear to involve activation of proinflammatory mediators similar to that seen with the classic systemic inflammatory response syndrome. DDX in any women with sudden cardiovascular collapse or cardiac arrest seizures, severe respiratory difficulty or hypoxia, particularly if such events are. We conducted an evidence-based review of information about corrected amniotic fluid embolism (AFE). The pathophysiology appears to involve an abnormal maternal response to fetal tissue exposure associated with breaches of the maternal-fetal physiologic barrier during parturition. Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%.
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