Amniotic Fluid Embolism Flashcards
1
Q
What is an amniotic fluid embolism?
A
An acute cardio-respiratory collapse within 6 hours after labour, birth or ruptured membranes
2
Q
What is the incidence?
A
1.7 : 100,000
3
Q
What are some initial signs of a potential AFE?
A
- Hypotension
- Chest pain
- Difficulty breathing
- Fetal compromise
- Maternal collapse
4
Q
Signs and symptoms of AFE?
A
- Hypotension
- Fetal compromise
- Bleeding
- Increased in respirations and pulse
- Convulsions
- Maternal reports of impending doom
5
Q
Management of AFE?
A
"2222" - OBSTETRIC EMERGENCY Assess airways - consider oxygen Cannulate Pulse ox IV infusion Urgent bloods - x match 4 units Coagulation screening (u's and e's, blood cultures, blood sugar) ECG and X-Ray Strict fluid balance Intubation Deliver fetus by C/S CPR
6
Q
What is the pathophysiology that causes an amniotic fluid embolism?
A
Tears in the fetal membranes and the uterine vessels can allow amniotic fluid to enter the uterine vein and enter the maternal pulmonary arterial circulation.. causing an inflammatory response similar to anaphylaxis (pulmonary vasospasm)
7
Q
What are some possible risk factors for an AFE?
A
- Uterine hyperstimulation
- Hypertonic contractions
- Eclampsia
- Polyhydramnious
- Multiple pregnancy
- Maternal age over >35 yrs
- Rapid birth