Amniotic fluid embolus: Difference between revisions
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##[[Pressors]] / [[blood products]] | ##[[Pressors]] / [[blood products]] | ||
#Avoid hypoperfusion | #Avoid hypoperfusion | ||
##Place | ##Place patient in left lateral decubitus position | ||
#Immediate delivery of fetus: | #Immediate delivery of fetus: | ||
##[[Perimortem C-section]] w/in 5min of cardiac arrest if mother cannot be resuscitated | ##[[Perimortem C-section]] w/in 5min of cardiac arrest if mother cannot be resuscitated | ||
Revision as of 18:53, 1 July 2016
Background
- Diagnosis of exclusion
- 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
Diagnosis
- Any of the following:
- Respiratory distress
- Pulmonary edema
- Hypoxia
- AMS
- Seizures
- Sudden maternal cardiovascular collapse
- DIC
Differential Diagnosis
3rd Trimester/Postpartum Emergencies
- Acute fatty liver of pregnancy
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- HELLP syndrome
- Mastitis
- Peripartum cardiomyopathy
- Postpartum endometritis (postpartum PID)
- Postpartum headache
- Postpartum hemorrhage
- Preeclampsia
- Resuscitative hysterotomy
- Retained products of conception
- Septic abortion
- Uterine rupture
Management
- Treat hypoxia
- NRB or intubate
- Treat hypotension
- Avoid hypoperfusion
- Place patient in left lateral decubitus position
- Immediate delivery of fetus:
- Perimortem C-section w/in 5min of cardiac arrest if mother cannot be resuscitated