Conde-Agudelo A, Romero R
Amniotic fluid embolism: an evidence-based review. [Journal Article, Research Support, N.I.H., Intramural]
Am J Obstet Gynecol 2009 Nov; 201(5):445.e1-13.
We reviewed the best evidence on amniotic fluid embolism (AFE). The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. The case fatality rate and perinatal mortality associated with AFE are 13-30% and 9-44%, respectively. Risk factors associated with increased risk of AFE include advanced maternal age, placental abnormalities, operative deliveries, eclampsia, polyhydramnios, cervical laceration, and uterine rupture. Hemodynamic response to AFE is biphasic, with initial pulmonary hypertension and right ventricular failure, followed by left ventricular failure. Promising therapies include selective pulmonary vasodilators and recombinant activated factor VIIa. Important topics for future research are presented.
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