Amniotic fluid embolus

Background

• Diagnosis of exclusion
• Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae

Risk Factors

1. Cesarean delivery
2. Advanced maternal age
3. Abnormal placental implantation
4. Uterine rupture
5. Eclampsia

Diagnosis

1. Any of the following:
   1. Respiratory distress
   2. Pulmonary edema
   3. Hypoxia
   4. AMS
   5. Seizures
   6. Sudden maternal cardiovascular collapse
   7. DIC

Management

1. Treat hypoxia
   1. NRB or intubate
2. Treat hypotension
   1. Pressors / blood products
3. Avoid hypoperfusion
   1. Place pt in left lateral decubitus position
4. Immediate delivery of fetus:
   1. Perimortem C-section w/in 5min of cardiac arrest if mother cannot be resuscitated

See Also

• DIC (Disseminated Intravascular Coagulation)

Source

Tintinalli