Amniotic fluid embolus - Revision history

Rossdonaldson1: /* Evaluation */

2021-11-25T12:43:48Z

Evaluation

← Older revision		Revision as of 12:43, 25 November 2021
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	[[File:PMC3030025 kjae-59-S158-g001.png\|thumb\|Post cesarean [[chest X-ray]] in a patient with acute amniotic fluid embolus.]]		[[File:PMC3030025 kjae-59-S158-g001.png\|thumb\|Post cesarean [[chest X-ray]] in a patient with acute amniotic fluid embolus.]]
	[[File:PMC2843707 1752-1947-4-55-2.png\|thumb\|[[Chest X-ray]] with diffuse infiltration throughout the lungs in a patient with acute amniotic fluid embolus.]]		[[File:PMC2843707 1752-1947-4-55-2.png\|thumb\|[[Chest X-ray]] with diffuse infiltration throughout the lungs in a patient with acute amniotic fluid embolus.]]
			[[File:PMC2843707 1752-1947-4-55-1.png\|thumb\|Chest CT showing homogeneous ground-glass opacities in a patient with acute amniotic fluid embolus.]]
	*Diagnosis of exclusion		*Diagnosis of exclusion
	*Consider [[CXR]] and/or chest CT		*Consider [[CXR]] and/or chest CT

2021-11-25T12:42:08Z

Evaluation

← Older revision		Revision as of 12:42, 25 November 2021
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	==Evaluation==		==Evaluation==
	[[File:PMC3030025 kjae-59-S158-g001.png\|thumb\|Post cesarean [[chest X-ray]] in a patient with amniotic fluid embolus.]]		[[File:PMC3030025 kjae-59-S158-g001.png\|thumb\|Post cesarean [[chest X-ray]] in a patient with acute amniotic fluid embolus.]]
			[[File:PMC2843707 1752-1947-4-55-2.png\|thumb\|[[Chest X-ray]] with diffuse infiltration throughout the lungs in a patient with acute amniotic fluid embolus.]]
	*Diagnosis of exclusion		*Diagnosis of exclusion
			*Consider [[CXR]] and/or chest CT

	==Management==		==Management==

2021-11-25T12:39:35Z

Evaluation

← Older revision		Revision as of 12:39, 25 November 2021
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	==Evaluation==		==Evaluation==
			[[File:PMC3030025 kjae-59-S158-g001.png\|thumb\|Post cesarean [[chest X-ray]] in a patient with amniotic fluid embolus.]]
	*Diagnosis of exclusion		*Diagnosis of exclusion

2020-06-07T00:46:31Z

Management

← Older revision		Revision as of 00:46, 7 June 2020
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	*Immediate delivery of fetus → Emergent c-section		*Immediate delivery of fetus → Emergent c-section
	**[[Resuscitative hysterotomy]] within 5min of cardiac arrest if mother cannot be resuscitated		**[[Resuscitative hysterotomy]] within 5min of cardiac arrest if mother cannot be resuscitated
			===A-OK Medications===
			''Only case reports have described the following three therapies''<ref>Rezai S. et al. Atypical Amniotic Fluid Embolism Managed with a NovelTherapeutic Regimen Case Reports in Obstetrics and Gynecology. 2017. https://www.researchgate.net/profile/Shadi_Rezai/publication/312332674_Atypical_Amniotic_Fluid_Embolism_AFE_Managed_With_A_Novel_Therapeutic_Regimen/links/5a3b50da458515a77aa99a21/Atypical-Amniotic-Fluid-Embolism-AFE-Managed-With-A-Novel-Therapeutic-Regimen.pdf</ref>
			#[[Atropine]] - 1mg IV
			#*Vagolytic properties may help
			#[[Ondansetron]] 8 mg IV
			#*Blocking of serotonin receptors can inhibits the release of more inflammatory mediators.
			#[[Ketorolac]] - 30mg IV
			#*Can block thromboxane production and prevent coagulopathies.

	==Disposition==		==Disposition==

2019-10-03T17:26:28Z

← Older revision		Revision as of 17:26, 3 October 2019
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	**[[Altered mental status]]		**[[Altered mental status]]
	**[[Seizures]]		**[[Seizures]]
	**Sudden maternal cardiovascular collapse		**Sudden maternal [[shock\|cardiovascular collapse]]
	**[[DIC]]		**[[DIC]]

2018-10-12T05:42:52Z

Background

← Older revision		Revision as of 05:42, 12 October 2018
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	*Maternal mortality rate ~80%		*Maternal mortality rate ~80%
	*85% of survivors have neurologic sequelae		*85% of survivors have neurologic sequelae
			*Occurs in 2-8 per 100,000 deliveries<ref>Fong A, Chau CT, Pan D, et al. Amniotic fluid embolism: antepartum, intrapartum and demographic factors. J Matern Fetal Neonatal Med. 2014 Jun 30. 1-6.</ref>
			**Responsible for ~10% of maternal mortality in US

	===Risk Factors===		===Risk Factors===

2018-10-12T05:40:17Z

Clinical Features

← Older revision		Revision as of 05:40, 12 October 2018
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	==Clinical Features==		==Clinical Features==
			*Typically occurs during labor and delivery or 30 minutes after delivery
	*Any of the following:		*Any of the following:
	**[[Respiratory distress]]		**[[Respiratory distress]]

2017-12-09T09:58:57Z

← Older revision		Revision as of 09:58, 9 December 2017
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	*Avoid hypoperfusion → Place patient in left lateral decubitus position		*Avoid hypoperfusion → Place patient in left lateral decubitus position
	*Immediate delivery of fetus → Emergent c-section		*Immediate delivery of fetus → Emergent c-section
	**[[~~Perimortem C-section~~]] within 5min of cardiac arrest if mother cannot be resuscitated		**[[Resuscitative hysterotomy]] within 5min of cardiac arrest if mother cannot be resuscitated

	==Disposition==		==Disposition==
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	==See Also==		==See Also==
	*[[~~Post-Partum Emergencies~~]]		*[[Postpartum emergencies]]

	==References==		==References==

2017-12-09T09:58:13Z

← Older revision		Revision as of 09:58, 9 December 2017
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	==Background==		==Background==
	*Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae		*Maternal mortality rate ~80%
			*85% of survivors have neurologic sequelae

	===Risk Factors===		===Risk Factors===
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	**[[Pulmonary edema]]		**[[Pulmonary edema]]
	**[[Hypoxia]]		**[[Hypoxia]]
	**[[~~altered~~ mental status]]		**[[Altered mental status]]
	**[[Seizures]]		**[[Seizures]]
	**Sudden maternal cardiovascular collapse		**Sudden maternal cardiovascular collapse
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	==Management==		==Management==
	*Treat hypoxia		*Treat hypoxia (may require intubation)
	**NRB or intubate		*Treat hypotension → [[Pressors]] / [[blood products]]
	*Treat hypotension		*Avoid hypoperfusion → Place patient in left lateral decubitus position
	**[[Pressors]] / [[blood products]]		*Immediate delivery of fetus → Emergent c-section
	*Avoid hypoperfusion
	**Place patient in left lateral decubitus position
	*Immediate delivery of fetus:
	**[[Perimortem C-section]] within 5min of cardiac arrest if mother cannot be resuscitated		**[[Perimortem C-section]] within 5min of cardiac arrest if mother cannot be resuscitated

2016-07-30T22:53:48Z

Text replacement - "AMS" to "altered mental status"

← Older revision		Revision as of 22:53, 30 July 2016
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	**[[Pulmonary edema]]		**[[Pulmonary edema]]
	**[[Hypoxia]]		**[[Hypoxia]]
	**[[~~AMS~~]]		**[[altered mental status]]
	**[[Seizures]]		**[[Seizures]]
	**Sudden maternal cardiovascular collapse		**Sudden maternal cardiovascular collapse