Documentation of amniotic fluid embolism via lung histopathology

Fact or fiction?

Gary Hankins, Russell Snyder, Tung Dinh, James Van Hook, Steven Clark, Adrian Vandelan

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate pulmonary histopathology for confirming amniotic fluid embolism. STUDY DESIGN: The Capra hircus (goat) model with fresh, homologous amniotic fluid was used. Raw fluid (n = 8), fluid filtered through a 5-μm filter (n=14) and meconium-stained fluid with 1-7% solid debris (n=7) were injected. Three hours after embolization the animals were euthanized and specimens collected. Three to five areas of lung were sampled based on the most abnormal areas visually. Traditional and special stains were utilized. The study protocol was approved by the institutional review board and animal use and care committee. Statistical analysis was by X2 with Yates correction. Significance was defined as P < .05. RESULTS: Amniotic fluid debris (fetal squames, mucin or foreign pigments) was found in 10 of 29 animals (34.5%). Debris was found in 7/7 (100%) of the meconium group, 2/8 (25%) of the raw fluid group and 1/14 of the filtered group (7%). The likelihood of finding debris in amniotic fluid embolism with meconium-stained fiuid was greater than with raw (P < .017) or filtered amniotic fiuid (P < .001). CONCLUSION: In this animal model, histopathologic confirmation of amniotic fluid embolism was an unreliable marker of the event except in cases of amniotic fluid embolism involving meconium-stained fluid.

Original languageEnglish (US)
Pages (from-to)1021-1024
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume47
Issue number12
StatePublished - Dec 1 2002

Fingerprint

Amniotic Fluid Embolism
Meconium
Documentation
Lung
Amniotic Fluid
Goats
Animal Care Committees
Research Ethics Committees
Mucins
Coloring Agents
Animal Models

Keywords

  • Amniotic fluid
  • Embolism
  • Lung
  • Meconium

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Documentation of amniotic fluid embolism via lung histopathology : Fact or fiction? / Hankins, Gary; Snyder, Russell; Dinh, Tung; Van Hook, James; Clark, Steven; Vandelan, Adrian.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 47, No. 12, 01.12.2002, p. 1021-1024.

Research output: Contribution to journalArticle

Hankins, Gary ; Snyder, Russell ; Dinh, Tung ; Van Hook, James ; Clark, Steven ; Vandelan, Adrian. / Documentation of amniotic fluid embolism via lung histopathology : Fact or fiction?. In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 2002 ; Vol. 47, No. 12. pp. 1021-1024.
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abstract = "OBJECTIVE: To evaluate pulmonary histopathology for confirming amniotic fluid embolism. STUDY DESIGN: The Capra hircus (goat) model with fresh, homologous amniotic fluid was used. Raw fluid (n = 8), fluid filtered through a 5-μm filter (n=14) and meconium-stained fluid with 1-7{\%} solid debris (n=7) were injected. Three hours after embolization the animals were euthanized and specimens collected. Three to five areas of lung were sampled based on the most abnormal areas visually. Traditional and special stains were utilized. The study protocol was approved by the institutional review board and animal use and care committee. Statistical analysis was by X2 with Yates correction. Significance was defined as P < .05. RESULTS: Amniotic fluid debris (fetal squames, mucin or foreign pigments) was found in 10 of 29 animals (34.5{\%}). Debris was found in 7/7 (100{\%}) of the meconium group, 2/8 (25{\%}) of the raw fluid group and 1/14 of the filtered group (7{\%}). The likelihood of finding debris in amniotic fluid embolism with meconium-stained fiuid was greater than with raw (P < .017) or filtered amniotic fiuid (P < .001). CONCLUSION: In this animal model, histopathologic confirmation of amniotic fluid embolism was an unreliable marker of the event except in cases of amniotic fluid embolism involving meconium-stained fluid.",
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