Amniotic fluid embolism: Analysis of the national registry

Steven L. Clark, Gary D.V. Hankins, Donald A. Dudley, Gary A. Dildy, T. Flint Porter

Research output: Contribution to journalArticle

473 Scopus citations

Abstract

OBJECTIVE: We analyzed the clinical course and investigated possible pathophysiologic mechanisms 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 ovent, only 39% survived. Clinical and hemodynamic manifestations were similar to those manifest in anaphytaxis 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
DOIs
StatePublished - Jan 1 1995

Keywords

  • Amniotic fluid embolism
  • fetal asphyxia
  • maternal mortality

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Clark, S. L., Hankins, G. D. V., Dudley, D. A., Dildy, G. A., & Porter, T. F. (1995). Amniotic fluid embolism: Analysis of the national registry. American journal of obstetrics and gynecology, 172(4), 1158-1169. https://doi.org/10.1016/0002-9378(95)91474-9