Amniotic fluid embolism Flashcards
1
Q
What is Amniotic fluid embolism? (aetiology, RF)
A
Obstetric emergency in which amniotic fluid and foetal cells enter maternal circulation-> cardioresp collapse
2: 100000 -rare but 5th highest maternity death cause
Aetiology- Unclear
Embolism provokes anaphylactic or complement cascade -> death
RF- often occurs without Increas maternal age Placenta praevia, induced labour C sections
2
Q
Sx and Ix of amniotic fluid embolism
A
Sx- Sudden onset SOB, cyanosis seizures Bleeding/DIC hypotension tachypnea, cardia, pulm oedema, uterine atony
Ix- ABG- hypoxemia FBC- Hb low Clotting - plt donw, PT/APTT up CXR - cardiomegaly, pulm oedema ECG- right heart strain
3
Q
Management of Amniotic fluid embolism
A
ABCDE approach and refer to ITU
ABC-
maintain airway
High flow O2 and intubate
2 large bore cannulae, fluid resus
pharm- ionotropics, correct coagulopathy with FFP, Plt, cryoprcipitates
Consider delivery + hysterscopy
75% survive with many sequlaea
25% die withing 12h
