Amniotic fluid embolism: Analysis of the national registry

S. L. Clark, Gary Hankins, D. A. Dudley, G. A. Dildy, T. Flint Porter

Research output: Contribution to journalArticle

461 Citations (Scopus)

Abstract

Objective: We analyzed the clinical course and investigated possible pathophysiologic mechanisms of amniotic fluid embolism. Study design: We carried out a retrospective review of medical records. Forty-six charts were analyzed for 121 separate clinical variables. Results: Amniotic fluid embolism occurred during labor in 70% of the women, after vaginal delivery in 11%, and during cesarean section after delivery of the infant in 19%. No correlation was seen with prolonged labor or oxytocin use. A significant relation was seen between amniotic fluid embolism and male fetal sex. Forty-one percent of patients gave a history of allergy or atopy. Maternal mortality was 61%, with neurologically intact survival seen in 15% of women. Of fetuses in utero at the time of the event, only 39% survived. Clinical and hemodynamic manifestations were similar to those manifest in anaphylaxis and septic shock. Conclusions: Intact maternal or fetal survival with amniotic fluid embolism is rare. The striking similarities between clinical and hemodynamic findings in amniotic fluid embolism and both anaphylaxis and septic shock suggest a common pathophysiologic mechanism for all these conditions. Thus the term amniotic fluid embolism appears to be a misnomer.

Original languageEnglish (US)
Pages (from-to)1158-1169
Number of pages12
JournalAmerican Journal of Obstetrics and Gynecology
Volume172
Issue number4 I
StatePublished - 1995
Externally publishedYes

Fingerprint

Amniotic Fluid Embolism
Registries
Anaphylaxis
Septic Shock
Hemodynamics
Survival
Maternal Mortality
Oxytocin
Cesarean Section
Medical Records
Hypersensitivity
Fetus
Mothers

Keywords

  • Amniotic fluid embolism
  • Fetal asphyxia
  • Maternal mortality

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Clark, S. L., Hankins, G., Dudley, D. A., Dildy, G. A., & Flint Porter, T. (1995). Amniotic fluid embolism: Analysis of the national registry. American Journal of Obstetrics and Gynecology, 172(4 I), 1158-1169.

Amniotic fluid embolism : Analysis of the national registry. / Clark, S. L.; Hankins, Gary; Dudley, D. A.; Dildy, G. A.; Flint Porter, T.

In: American Journal of Obstetrics and Gynecology, Vol. 172, No. 4 I, 1995, p. 1158-1169.

Research output: Contribution to journalArticle

Clark, SL, Hankins, G, Dudley, DA, Dildy, GA & Flint Porter, T 1995, 'Amniotic fluid embolism: Analysis of the national registry', American Journal of Obstetrics and Gynecology, vol. 172, no. 4 I, pp. 1158-1169.
Clark SL, Hankins G, Dudley DA, Dildy GA, Flint Porter T. Amniotic fluid embolism: Analysis of the national registry. American Journal of Obstetrics and Gynecology. 1995;172(4 I):1158-1169.
Clark, S. L. ; Hankins, Gary ; Dudley, D. A. ; Dildy, G. A. ; Flint Porter, T. / Amniotic fluid embolism : Analysis of the national registry. In: American Journal of Obstetrics and Gynecology. 1995 ; Vol. 172, No. 4 I. pp. 1158-1169.
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