AFE Flashcards
1
Q
AFE definition/pathophys
A
Amniotic fluid and associated debris enters the maternal circulation, causing a anaphylactic type reaction, obstruction to pulmonary vessels, complement activation —> clotting problems
70% during labour
19% at c/s
11% PP
2
Q
symptoms and signs
A
Breathlessness, chest pain, feeling cold, light headed, nausea vomiting, cyanosis, pins and needles
Sudden hypotension, hypoxia, resp distress Cardiopulmonary arrest (87%) DIC (83%) Pulmonary oedema Seizures Fetal distress Pink frothy sputum Bleeding from IV sites
3
Q
Management
A
Bloods:fbs, coag with fibrinogen degredation products
CXR ?pulm oedema
ECG
Resus MDT Del baby Liase with haem to correct coagulopathy Treat haemorrhage - crosshatch 6-10units Circ support - ionotropes ITU
4
Q
Mortality rate
A
61%
Of those that survive, only 15% neurologically intact
5
Q
Incidence
A
6 per 100000
14% fatality
6
Q
Risk factors for AFE
A
AMA (35 or older) Placental problems/abruption PET IOL Operative delivery Polyhydramnios Multiparity Caesarean section Trauma Rapid labour/uterine hypertonus
