Obstetric emergencies often require intensive care intervention. Amniotic fluid embolism is a rare, unpredictable, and often catastrophic complication of pregnancy that is suspected in a woman who experiences cardiac arrest after a cesarean section. The condition occurs in approximately 1 in 40 000 births and has an average case-fatality rate of 16%. This complication may result from activation of an inflammatory response to fetal tissue in the maternal circulation. Risk factors may include maternal age over 35 years and conditions in which fluid can exchange between the maternal and fetal circulations. The presentation is abrupt, with profound cardiovascular and respiratory compromise, encephalopathy, fetal distress, and disseminated intravascular coagulopathy. Diagnosis is by exclusion and clinical presentation. Treatment is supportive, with a focus on reversal of hypoxia and hypotension, delivery of the fetus, and correction of coagulopathy. Staff debriefing and psychological support for the woman and family are vital.
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Fall 2018
Symposium: Critical Care Obstetrics|
September 15 2018
Clinical Presentation and Treatment of Amniotic Fluid Embolism
Anne-Marie McBride, MCN (Critical Care Nursing), RN
Anne-Marie McBride, MCN (Critical Care Nursing), RN
Anne-Marie McBride is Clinical Nurse, Intensive Care, Calvary North Adelaide Hospital, 23 Strangways Terrace, North Adelaide, 5006 Australia ([email protected]).
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AACN Adv Crit Care (2018) 29 (3): 336–342.
Citation
Anne-Marie McBride; Clinical Presentation and Treatment of Amniotic Fluid Embolism. AACN Adv Crit Care 15 September 2018; 29 (3): 336–342. doi: https://doi.org/10.4037/aacnacc2018419
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