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Anaphylactoid Syndrome/Amniotic Fluid Embolism

Elizabeth R. Allocco, MD Reviewed 05/2023
 


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.

  • Maternal shortness of breath, hypotension, mental status chang...

TREATMENT

GENERAL MEASURES

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

    • Manual left uterine displacement during CPR to relieve aortocaval compression, maximize...

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
Knight  M, Tuffnell  D, Brocklehurst  P, et al; for UK Obstetric Surveillance System. Incidence and risk factors for amniotic-fluid embolism. Obstet Gynecol.  ...

ADDITIONAL READING

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 cardiopulmonary event occurring during labor or shortly after delivery.

  • Provision of immediate, resource-intensive resuscitative and supportive care is critical ...

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