文档介绍：Amniotic Fluid Embolism
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You should rember!
It is axiomatic that when a choice must be made, maternal considerations take perference over those of the fetus
Prognosis
Perinatal es are dismal with amniotic fluid embolism. Few conditions in medicine have potential for such sudden devastation. We are aware of one case during labor in which mother and baby not only died, but the visiting grandmother also suffered a fatal myocardial infarction during resuscitation efforts on her daughter!
Defition
Amniotic Fluid Embolism is plex condition characterized by the abrupt onset of pulmonary embolism, shock and DIC.
Incidence varies greatly.
Etiology
Pressure increasing:
uterinehypertonus,tetanic,oxytocin
open vessles:traumatic, laceration
membrane changing:fetal death,dystocia
pathophysiology
Emblus(amniotic ponent+fibrin)-----allergic reaction
--mechanic block+vagus nerve(spasm)----blood return decreasing---peripheral circulation faiture
--hypertetion of pulmonary artery---pulmonary edema---left heart faiure+respiratory failure
--coagulopathy---DIC
--general ischemia—renal failure
Clinical manifestation
A. time of onset
B. circulation and respiratory failure
C. shock, DIC----bleeding
D. renal failure
diagnosis
Emergent : typical clinical manifestation
Pulmonary edema
Definitive diagnosis: aspiration:debris +DIC
autopsy
treatment
R&C failure
coagulopathy, DIC, renal dysfunction
-allergic reaction
management
Chapter 20 ic counseling, ic screening, prenatal diagnosispage202