1/39. Lung mass due to amniotic fluid embolism--an intrathoracic complication of pregnancy.A 29-year-old woman with right chest pain was admitted for radiographic investigation and found to have a round mass in the right lower zone. This was initially suspected to be a hydatid lung cyst but was confirmed as a cystic mass by computed tomography and duly excised. Histologic examination revealed an amniotic fluid embolism. The patient had had a stillbirth three months earlier.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/39. amniotic fluid embolism: a case report and review.A 41-year old primigravida underwent caesarean section because of foetal distress following prostin induction of labour. Intraoperative coagulopathy, haemorrhage and hypotension necessitated a hysterectomy. Subsequently, she developed respiratory and renal failure, requiring mechanical ventilation and haemodialysis. She made a full recovery. The likely diagnosis was amniotic fluid embolism (AFE), a rare complication of pregnancy with a variable presentation, ranging from cardiac arrest and death through to mild degrees of organ system dysfunction with or without coagulopathy. The differential diagnosis includes pre-eclamptic toxaemia/pregnancy-induced hypertension, anaphylaxis and pulmonary embolism. There is no diagnostic test for AFE; the finding of foetal elements in the maternal circulation is non-specific. Historically, AFE was thought to induce cardiovascular collapse by mechanical obstruction of the pulmonary circulation. It is now thought that a combination of left ventricular dysfunction and acute lung injury occur, with activation of several of the clotting factors. An immunological basis for these effects is postulated. There is no specific therapy and treatment is supportive. The mortality of the condition remains high.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
3/39. Occlusions of branch retinal arterioles following amniotic fluid embolism.amniotic fluid embolism is a serious complication of pregnancy with a high mortality. We present a 28-year-old healthy woman who underwent dilatation and curettage for an elective abortion, followed by the sudden loss of vision in her left eye. Occlusion of one branch retinal arteriole was the initial finding of her left fundus, and two occlusions developed consecutively on the color fundus photographs. fluorescein angiography demonstrated occlusions in three retinal arterioles among seven retinal arterioles originating from the optic disc. These findings suggest that possible mechanisms of amniotic fluid embolism are the unusual cause in retinal arteriolar occlusions. Here clinical course and ophthalmic findings are reviewed, and the relationship between amniotic fluid embolism and retinal arteriolar occlusions is discussed.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
4/39. amniotic fluid embolism.amniotic fluid embolism is a rare occurrence, with no single pathognomonic clinical or laboratory finding. diagnosis is based on clinical presentation and supportive laboratory values. We describe the case of a 17-year-old nulliparous woman at 27 weeks' gestation who had uterine bleeding, hematuria, hemoptysis, hypotension, dyspnea, and hypoxemia within 30 minutes of vaginal delivery. Laboratory values revealed diffuse intravascular coagulation. Chest films were consistent with adult respiratory distress syndrome. pulmonary artery catheterization revealed moderately increased pulmonary capillary wedge pressure. Supportive measures, including oxygenation, fluid resuscitation, and plasma, were administered. Central hemodynamic monitoring and inotropic support were necessary. Our patient recovered uneventfully and 6 weeks later was living an unrestricted life-style.- - - - - - - - - - ranking = 0.094122238303403keywords = gestation (Clic here for more details about this article) |
5/39. Successful pregnancy after suspected anaphylactoid syndrome of pregnancy (amniotic fluid embolus). A case report.BACKGROUND: Limited information is available on the recurrence risk of anaphylactoid syndrome of pregnancy. CASE: A successful pregnancy followed suspected anaphylactoid syndrome of pregnancy. CONCLUSION: A review of the literature revealed five cases of successful subsequent pregnancies following anaphylactoid syndrome of pregnancy. No instances of recurrent anaphylactoid syndrome of pregnancy have been reported.- - - - - - - - - - ranking = 3.25keywords = pregnancy (Clic here for more details about this article) |
6/39. amniotic fluid embolism and isolated coagulopathy: atypical presentation of amniotic fluid embolism.A 41-year-old multigravida presented at 32 weeks of gestation with polyhydramnios and an anencephalic fetus. Abnormal bleeding as a result of disseminated intravascular coagulation complicated an emergency Caesarean section for severe abdominal pain thought to be due to uterine rupture. Massive transfusion with blood products was necessary and the abdomen packed to control bleeding. The patient was transferred to the intensive care unit where she made a slow but complete recovery. amniotic fluid embolism with atypical presentation of isolated coagulopathy is the likely diagnosis in this case. The case serves to demonstrate that amniotic fluid embolism may present with symptoms and signs other than the classical pattern of dyspnoea, cyanosis and hypotension.- - - - - - - - - - ranking = 0.094122238303403keywords = gestation (Clic here for more details about this article) |
7/39. serum tryptase analysis in a woman with amniotic fluid embolism. A case report.BACKGROUND: Recent studies have noted a striking similarity between amniotic fluid embolism (AFE) and anaphylaxis. serum tryptase levels may therefore serve as a marker of mast cell degranulation in AFE cases. CASE: A 40-year-old woman, gravida 6, para 4, experienced the acute onset of facial erythema, eclampsia-type seizures, severe hypoxia, cardiac arrest and disseminated intravascular coagulation while in early active labor. The patient was declared dead 37 minutes after the onset of resuscitative efforts. At autopsy, fetal squames were found within the pulmonary tree, uterine blood vessels and brain. A peripheral venous blood specimen, obtained approximately one and a half hours postmortem, revealed a tryptase level of 4.7 ng/mL (normal, < 1). CONCLUSION: An elevated serum tryptase level, in conjunction with our patient's clinical history, adds further supporting evidence to the concept of AFE as an anaphylactoid syndrome of pregnancy.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
8/39. Non-fatal amniotic fluid embolism after cervical suture removal.We describe a case of pulmonary oedema occurring at 37 weeks gestation, following the attempted removal of a cervical suture under general anaesthesia. The use of an ultrasound technique to demonstrate the patient's fluid status is described. Signs of amniotic fluid embolism and how it exerts its influence on the circulation are discussed.- - - - - - - - - - ranking = 0.094122238303403keywords = gestation (Clic here for more details about this article) |
9/39. amniotic fluid embolism with involvement of the brain, lungs, adrenal glands, and heart.The case of a healthy 31-year-old woman in the 40th week of second pregnancy is presented. During preparation for an emergency caesarean section, she developed an amniotic fluid embolism (AFE) with unusual and unique features. The acute onset of disease with cardiorespiratory failure with hypotension, tachycardia, cyanosis, respiratory disturbances and loss of consciousness, suggested at first a pulmonary thromboembolism, but the appearance of convulsions led to the diagnosis of AFE. The patient died after 5 days due to an untreatable brain edema. At autopsy, AFE with the usually associated disseminated intravascular coagulation was found in the lungs, brain, left adrenal gland, kidneys, liver and heart. Eosinophilic inflammatory infiltrates were found in the lungs, hepatic portal fields and especially in the heart, suggesting a specific hypersensitivity reaction to fetal antigens. Moreover, intravascular accumulation of macrophages in the lungs also favored a non-specific immune reaction to amniotic fluid constituents.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
10/39. Presumed antepartum amniotic fluid embolism.BACKGROUND: amniotic fluid embolism is seldom recognized in nonperipartum patients. The pathophysiology is uncertain and diagnosis imprecise, making management after stabilization difficult. CASE: A 37-year-old woman at 28 weeks' gestation presented with signs and symptoms consistent with amniotic fluid embolism including disseminated intravascular coagulopathy. A ventilation-perfusion scan demonstrated unmatched perfusion defects, but other radiographic studies were negative; the patient was treated with heparin. Four days after presentation she had spontaneous rupture of membranes followed by hypoxemia, necessitating cesarean delivery. A pulmonary arteriogram after the operation showed multiple filling defects; the patient was discharged on warfarin. CONCLUSION: amniotic fluid embolism is a difficult diagnosis to make, at best. Anticoagulation may be a therapeutic option.- - - - - - - - - - ranking = 0.094122238303403keywords = gestation (Clic here for more details about this article) |
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