Diferencia entre revisiones de «Amniotic fluid embolus»
(Text replacement - "AMS" to "altered mental status") |
|||
| Línea 16: | Línea 16: | ||
**[[Pulmonary edema]] | **[[Pulmonary edema]] | ||
**[[Hypoxia]] | **[[Hypoxia]] | ||
**[[ | **[[altered mental status]] | ||
**[[Seizures]] | **[[Seizures]] | ||
**Sudden maternal cardiovascular collapse | **Sudden maternal cardiovascular collapse | ||
Revisión del 22:53 30 jul 2016
Background
- Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae
Risk Factors
- Cesarean delivery
- Advanced maternal age
- Abnormal placental implantation
- Uterine rupture
- Eclampsia
- Amniocentesis
- Trauma
Clinical Features
- Any of the following:
- Respiratory distress
- Pulmonary edema
- Hypoxia
- altered mental status
- Seizures
- Sudden maternal cardiovascular collapse
- DIC
Differential Diagnosis
3rd Trimester/Postpartum Emergencies
- Acute fatty liver of pregnancy
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- HELLP syndrome
- Mastitis
- Peripartum cardiomyopathy
- Postpartum endometritis (postpartum PID)
- Postpartum headache
- Postpartum hemorrhage
- Preeclampsia
- Resuscitative hysterotomy
- Retained products of conception
- Septic abortion
- Uterine rupture
Evaluation
- Diagnosis of exclusion
Management
- Treat hypoxia
- NRB or intubate
- Treat hypotension
- 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
Disposition
- Admit