Amniotic Fluid embolism Page 251
Amniotic Fluid Embolism Page 251
You should rember It is axiomatic that when a choice must be made. maternal considerations take perference over those of the fetus
You should rember! • It is axiomatic that when a choice must be made, maternal considerations take perference over those of the fetus
Prognosis Perinatal outcomes are dismal with amniotic fluid embolism. Few conditions in medicine have potential for such sudden devastation We are aware of one case during labor in which mother and baby not only died, but the visiting grandmother also suffered a fatal myocardial infarction during resuscitation efforts on her daughter!
Prognosis • Perinatal outcomes are dismal with amniotic fluid embolism. Few conditions in medicine have potential for such sudden devastation. We are aware of one case during labor in which mother and baby not only died, but the visiting grandmother also suffered a fatal myocardial infarction during resuscitation efforts on her daughter!
Defition Amniotic Fluid Embolism is a complex condition characterized by the abrupt onset of pulmonary embolism, shock and DIC Incidence varies greatly
Defition • Amniotic Fluid Embolism is a complex condition characterized by the abrupt onset of pulmonary embolism, shock and DIC. • Incidence varies greatly
Etiology Pressure increasing uterinehypertonus, tetanic, oxytocin open vessles. traumatic, laceration membrane changing fetal death, dystocia
Etiology • Pressure increasing: • uterinehypertonus,tetanic,oxytocin • open vessles:traumatic, laceration • membrane changing:fetal death,dystocia
pathophysiology Emblus(amniotic fluid component+fibrin) allergic reaction mechanic block +vagus nerve(spasm)----blood return decreasing---peripheral circulation faiture lypertetion of pulmonary artery---pulmonary edema---left heart falure+respiratory failure -coagulopathy---Dl general ischemia-enal failure
pathophysiology • Emblus(amniotic fluid component+fibrin)----- allergic reaction • --mechanic block+vagus nerve(spasm)----blood return decreasing---peripheral circulation faiture • --hypertetion of pulmonary artery---pulmonary edema---left heart faiure+respiratory failure • --coagulopathy---DIC • --general ischemia—renal failure
Clinical manifestation A time of onset B circulation and respiratory failure C shock, DIC----bleeding D. renal failure
Clinical manifestation • A. time of onset • B. circulation and respiratory failure • C. shock, DIC----bleeding • D. renal failure
di agnosis Emergent: typical clinical manifestation Pulmonary edema Definitive diagnosis: aspiration debris +DIC autopsy
diagnosis • Emergent : typical clinical manifestation • Pulmonary edema • Definitive diagnosis: aspiration:debris +DIC • autopsy
treatment 1. correct r&c failure 2.correct coagulopathy, DIC, renal dysfunction 3. Anti-allergic reaction 4. obstetric management
treatment • 1.correct R&C failure • 2.correct coagulopathy, DIC, renal dysfunction • 3.Anti-allergic reaction • 4.obstetric management
Chapter 20 genetic counseling, genetic screening, prenatal diagnosispage202
Chapter 20 genetic counseling, genetic screening, prenatal diagnosispage202