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Amniotic fluid embolus
From WikEM
(Redirected from Amniotic Fluid Embolus)
Contents
Background
- Maternal mortality rate ~80%; 85% of survivors have neurologic sequelae
Risk Factors
- Cesarean delivery
- Advanced maternal age
- Abnormal placental implantation
- Uterine rupture
- Eclampsia
- Amniocentesis
- Trauma
Clinical Features
- Any of the following:
- Respiratory distress
- Pulmonary edema
- Hypoxia
- altered mental status
- Seizures
- Sudden maternal cardiovascular collapse
- DIC
Differential Diagnosis
Postpartum Emergencies
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- Postpartum endometritis
- Postpartum headache
- HELLP syndrome
- Postpartum hemorrhage
- Mastitis
- Peripartum cardiomyopathy
- Preeclampsia
- Retained products of conception
- Uterine rupture
Evaluation
- Diagnosis of exclusion
Management
- Treat hypoxia
- NRB or intubate
- Treat hypotension
- Avoid hypoperfusion
- Place patient in left lateral decubitus position
- Immediate delivery of fetus:
- Perimortem C-section within 5min of cardiac arrest if mother cannot be resuscitated
Disposition
- Admit
