Amniotic Fluid Embolism

被引:111
作者
Gist, Richard S.
Stafford, Irene P. [2 ]
Leibowitz, Andrew B.
Beilin, Yaakov [1 ,3 ]
机构
[1] NYU, Dept Anesthesiol, Mt Sinai Med Ctr, Mt Sinai Sch Med, New York, NY 10029 USA
[2] Univ Texas SW Med Ctr Dallas, Dept Obstet & Gynecol, Dallas, TX 75390 USA
[3] NYU, Dept Obstet & Gynecol, Mt Sinai Sch Med, New York, NY 10029 USA
关键词
MATERNAL PULMONARY CIRCULATION; RECOMBINANT FACTOR VIIA; MAST-CELL TRYPTASE; POSTPARTUM HEMORRHAGE; COAGULATION; PREGNANCY; COMPLICATIONS; MANAGEMENT; APROTININ; DIAGNOSIS;
D O I
10.1213/ane.0b013e31819e43a4
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Amniotic fluid embolism is one of the most catastrophic complications of pregnancy. First described in 1941, the condition is exceedingly rare and the exact pathophysiology is still unknown. The etiology was thought to be embolic in nature, but more recent evidence suggests an immunologic basis. Common presenting symptoms include dyspnea, nonreassuring fetal status, hypotension, seizures, and disseminated intravascular coagulation. Early recognition of amniotic fluid embolism is critical to a Successful outcome. However, despite intensive resuscitation, outcomes are frequently poor for both infant and mother. Recently, aggressive and successful management of amniotic fluid embolism with recombinant factor VIIa and a ventricular assist device, inhaled nitric oxide, cardiopulmonary bypass and intraaortic balloon pump with extracorporeal membrane oxygenation have been reported and should be considered in select cases.
引用
收藏
页码:1599 / 1602
页数:4
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