Amniotic fluid embolism is rare and unexpected but a life-threatening complication of pregnancy is accompanied by a high mortality rate. This syndrome usually occurs at the time of delivery. Classical clinical features are sudden onset of circulatory collapse, acute respiratory distress, disseminated intravascular coagulation and neurological impairment like seizure. The diagnosis is made by identifying clinically characteristics symptoms, and by exclusion of other cause. We report one case of a patient with amniotic fluid embolism, which showed atypical symptoms like seizure.
Amniotic Fluid* ; Diagnosis ; Disseminated Intravascular Coagulation ; Embolism, Amniotic Fluid* ; Female ; Humans ; Mortality ; Pregnancy ; Seizures* ; Shock

OBJECTIVE: To establish the diagnosis of amniotic fluid embolism with blood samples by liquid-based cytology technique and to study the validity of method. METHODS: The blood samples were collected from patients who suffered from amniotic fluid embolism. The components of amniotic fluid in blood samples were examined with blood smear by two direct smear methods (supernatant smear, sediment smear) and two liquid-based cytology methods (automatic smear, manual smear). The positive detection rate of each method was calculated. RESULTS: The positive detection rates of two liquid-based cytology methods (84.6% and 92.3%, respectively) were much higher than those of two direct methods (53.8% and 61.5%, respectively). CONCLUSION The liquid-based cytology technique could improve the positive detection rate of amniotic fluid embolism.
Amniotic Fluid ; Cytological Techniques/methods* ; Embolism, Amniotic Fluid/diagnosis* ; Female ; Humans ; Pregnancy

Amniotic fluid embolism continues to be a life-threatening. It is an unexpected and rare complication of pregnancy often presenting with sudden maternal cardiovascular collapse, disseminated intravascular coagulation (DIC), and maternal death. In the past, the diagnosis of amniotic fluid embolism was made when a woman presented with one of those clinical hallmarks and at autopsy fetal squamous and amniotic fluid cells were found within the maternal pulmonary arteries. However, several studies have demonstrated that squamous cells, trophoblasts, and other debris of fetal origin may commonly be found in the central circulation of women with conditions other than amniotic fluid embolism. Thus, this finding is neither sensitive nor specific. We present a case that was diagnosed clinically as amniotic fluid embolism by characteristic signs and symptoms during the labor, resulting in maternal death.
Amniotic Fluid* ; Autopsy ; Dacarbazine ; Diagnosis ; Disseminated Intravascular Coagulation ; Embolism, Amniotic Fluid* ; Female ; Humans ; Maternal Death ; Pregnancy ; Pulmonary Artery ; Trophoblasts

Amniotic fluid embolism, one of the leading causes of maternal death, is a rare event, however, it can cause maternal death and neonatal morbidity when it unrecognized and untreated effectively. Its pathogenesis is unclear and clinical presentations are variable without standardized means of confirming diagnosis. We experienced one case of neonatal hypoxic ischemic encephalopathy possibly due to maternal amniotic fluid embolism, which was diagnosed by brain MRI, EEG and maternal uterine pathology. We report this case with a brief review of literatures.
Amniotic Fluid* ; Brain ; Diagnosis ; Electroencephalography ; Embolism, Amniotic Fluid* ; Female ; Hypoxia-Ischemia, Brain* ; Magnetic Resonance Imaging ; Maternal Death ; Pathology ; Pregnancy

Ammiotic fluid embolism(AFE) is an often-devastating condition of pregnancy with high mortality. The diagnosis of amniotic fluid embolism is generally made postmortem and rests upon the morphological demonstration of amniotic fluid debris including fetal epithelial squames and hair in the pulmonary vasculature. We have made the diagnosis of amniotic fluid embolism by detection of amniotic fluid debris in cervical blood vessels ension with profuse postpartum hemorrhage and evidence of disseminated intravascular coagulation, cervical laceration after uneventful delivery. Amniotic fluid debris were only demonstrated in the blood vessels of cervical laceration site. We present a case of amniotic fluid embolism which was diagnosed at postpartum hysterectomy specimen via thorough histological examination.
Amniotic Fluid ; Blood Vessels ; Diagnosis ; Disseminated Intravascular Coagulation ; Embolism* ; Embolism, Amniotic Fluid ; Female ; Hair ; Hysterectomy ; Lacerations ; Mortality ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy

Adult ; Embolism, Amniotic Fluid ; blood ; diagnosis ; surgery ; Female ; Humans ; Hysterectomy ; Pregnancy ; Uterus ; pathology ; surgery

Amniotic fluid embolism (AFE) is a rare peripartum complication with a mortality rate of 61 to 86%. The main clinical manifestations include shock, acute pulmonary edema, neurologic signs, and coagulopathies. Most diagnosis of AFE is made on the postmortem examination of the maternal pulmonary vasculature, but antemortem confirmation of amniotic fluid material by aspiration of pulmonary blood is rare. We report the first case in Korea who survived from amniotic fluid embolism confirmed by the identification of amniotic fluid debris in pulmonary artery blood. Serial echocardiographic changes of left ventricle systolic dysfunction are also described with a brief review of literatures.
Amniotic Fluid* ; Autopsy ; Diagnosis ; Echocardiography ; Embolism, Amniotic Fluid* ; Female ; Heart Ventricles* ; Korea ; Mortality ; Neurologic Manifestations ; Peripartum Period ; Pregnancy ; Pulmonary Artery ; Pulmonary Edema ; Shock

Amniotic Fluid ; metabolism ; Biomarkers ; metabolism ; Diagnosis, Differential ; Embolism, Amniotic Fluid ; metabolism ; pathology ; Female ; Humans ; Infant, Newborn ; Keratin-13 ; metabolism ; Pregnancy ; Respiratory Aspiration ; metabolism ; pathology

OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

Cardiac arrest one day after cesarean section is extremely rare. Obstetrical clinicians have low experience to these serious situations necessitating immediate first aid and knowledge of its differential diagnosis. A 33-year-old woman underwent elective repeat cesarean section at 38 weeks of gestation under spinal anesthesia. The patient underwent uneventful course on that day. Loss of consciousness occurred one day after cesarean section during her first ambulation. Immediate cardiac compression was performed and eventually resulted in good recovery of her heartbeat. Her condition was suitable disseminated intravascular coagulation (DIC). She developed acute ischemic pancreatitis after cardiac arrest. We describe the consideration of amniotic fluid embolism with DIC as most appropriate in this case. To our knowledge, our case is one of the most dangerous conditions after the cesarean section. Here, we report our case with a review of literatures.
Adult ; Anesthesia, Spinal ; Cesarean Section ; Cesarean Section, Repeat ; Dacarbazine ; Death, Sudden, Cardiac* ; Diagnosis, Differential ; Disseminated Intravascular Coagulation ; Embolism, Amniotic Fluid ; Female ; First Aid ; Heart Arrest ; Humans ; Pancreatitis ; Pregnancy ; Pulmonary Embolism* ; Unconsciousness ; Walking