Medical Academy named after S. I. Georgievsky

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MINISTRY OF EDUCATION AND SCIENCE OF RUSSIAN FEDERATION

Federal State Autonomous Educational Institution of Higher Education

V. I. VERNADSKY CRIMEAN FEDERAL UNIVERSITY

Medical Academy named after S. I. Georgievsky

ABSTRACT

SUBJECT: AMNIOTIC FLUID EMBOLISM (AFE)

STUDENT: PENUMALA RAJ WILSON

FACULTY: INTERNATIONAL MEDICAL FACULTY

COURSE: 4^TH

GROUP: La1 – Co – 173(1)

NAME OF PRACTICE: GYNECOLOGY AND OBSTETRICS HOSPITAL CLASS

DURATION OF PRACTICE: from_____05/07/2021_____________till ____16/07/2021__________________

Simferopol, 2021

INTRODUCTION

Amniotic fluid embolism (AFE) is one of the most calamitous complications in which amniotic fluid, fetal cells, hair, or other debris enters the maternal pulmonary circulation, causing cardiovascular collapse It was first reported by Meyer and first described by Steiner and Lushbaugh[1][2][3]. exact cause still remains unknown. but can mainly occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the 2nd trimester of pregnancy and also can also occur during abortion, during abdominal trauma and also during amnio-infusion. pathophysiology is incompletely understood and suggest that amniotic fluid gains entry into maternal blood stream Leads to mechanical block or release of endogenous mediators causing pulmonary vessel obstruction and vasospasm that leads to acute pulmonary hypertension, acute dyspnea, cough, hypotension, cyanosis, fetal bradycardia, encephalopathy, life threatening problems with blood clotting(DIC), hypoxemia, right heart failure results in death. Recent evidence suggests that the occurrence of AFE is not a consequence of the “simple” mechanical respiratory obstruction, but a humoral effect causing anaphylactoid reactions or complement activation. [2] The process is similar to anaphylaxis than to embolism, so also termed as anaphylactoid syndrome of pregnancy because fetal tissue or amniotic fluid components are not universally found in women who present with signs and symptoms attributable to AFE. [4][5][6] In some women, AFE may lead to a mild degree of organ dysfunction while in others it may lead to coagulopathy, cardiovascular collapse, and death. [7][8] It is diagnosed by Blood tests by evaluate clotting, enzymes of heart, electrolytes, blood type, (CBC), Electrocardiogram for evaluating the rhythm of heart, Pulse oximetry to check the amount of oxygen Chest X-ray to find the presence of fluid around heart. The treatment is based in early recognition and prompt and competitive resuscitative efforts, retaining vital functions and transfusing blood products. Some authors even recommend for the introduction of algorithms to control DIC in those patients, as the treatment requires a large quantity of blood products, thinking about the transfusion of fibrinogen in the early phases and of recombinant factor VIIa as a rescue therapy. [9][10]

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