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Anaphylactoid Syndrome/Amniotic Fluid Embolism

Elizabeth R. Allocco, MD and Julianne Lauring, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Amniotic fluid embolism (AFE) is a syndrome associated with cardiorespiratory collapse during pregnancy or shortly after delivery.

  • Classically includes a triad of hypoxia, hypotension...

DIAGNOSIS

HISTORY

  • Premonitory symptoms are first presenting symptom in many of cases: tingling, numbness, anxiety, sense of impending doom.

  • Shortness of breath, hypotension, maternal mental status chang...

TREATMENT

GENERAL MEASURES

  • Immediate cardiopulmonary resuscitation (CPR) with high quality CPR-ACLS and call for help

    • Left uterine displacement during CPR to relieve compression of IVC, maximize venou...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

ICU monitoring until hemodynamically stable 

DIET

  • NPO with aggressive resuscitation with IV fluids, such as normal saline and blood products as ne...

REFERENCES

1
Clark SL, Hankins GD, Dudley DA, et al. Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol.  1995;172(4, Pt 1):1158–1167. [View Abstract on OvidMedline]
2
K...

ADDITIONAL READING

  • Clark SL. Amniotic fluid embolism. Obstet Gynecol.  2014;123(2, Pt 1):337–348. [View Abstract on OvidMedline]

  • Conde-Agudelo A, Romero R. Amniotic fluid embolism: an evidence-bas...

SEE ALSO

Disseminated Intravascular Coagulation 

CODES

ICD10

  • O88.13 Amniotic fluid embolism in the puerperium

  • O03.2 Embolism following incomplete spontaneous abortion

  • O07.2 Embolism following failed attempted termination of pregnancy

  • O04.7 Embolism foll...

CLINICAL PEARLS

  • AFE is a rare, critical event occurring during labor or shortly after delivery.

  • Provision of immediate, resource-intensive supportive care is critical to survival.

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