Amniotic Fluid Embolism Flashcards
1
Q
What are the risk factors for an amniotic fluid embolism
A
- Multiple pregnancy
- Increasing maternal age
- Induction of labour
- Uterine rupture
- Placenta praevia
- Placental abruption
- Cervical laceration
- Eclampsia
- Polyhydramnios
- Caesarean or instrumental delivery
2
Q
What are the clinical features of an amniotic fluid embolism
A
Sudden onset:
- Hypoxia/respiratory arrest
- Hypotension
- Fetal distress
- Seizures
- Shock
- Confusion
- Cardiac arrest
- DIC
3
Q
How should an amniotic fluid embolism be investigated?
A
Bloods = FBC, U+Es, Ca, Mg, clotting, ABG
ECG = ischemic changes
CXR = pulmonary oedema
Pulmonary artery wedge pressure
4
Q
How should a amniotic fluid embolism be managed
A
A-E
Oxygen
Fluids
DIC - involve haematologist
Fetal monitoring
Perimortem section - indicted to facilitate CPR
5
Q
How is an amniotic fluid embolism diagnosed?
A
Definitive diagnosis of amniotic fluid embolism is only definitively confirmed on post mortem and demonstrates fetal squamous cells along with debris in the pulmonary vasculature
