Management of intrapartum maternal cardiopulmonary collapse secondary to Amniotic fluid embolism
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Keywords:
Amniotic fluid embolism
Maternal death
Objective:To explore the causes and affecting factors of maternal death in Henan,to study surveillance and intervention of maternal mortality ratio for descent maternal mortality ratio.Methods:The data from 25 monitoring stations of Henan from 1996 to 2008 were retrospectively analyzed.Results:Number of Live-births was 1 077 from 1996 to 2008 in Henan,the maternal mortality ratio was 49.33/100 000 of them,125 cases were in city,the maternal mortality ratio was 24.19/100 000;952 cases were in rural,the maternal mortality ratio was 57.13/100 000.The maternal mortality ratio was 22.16/100 000 in 2008 and 54.53/100 000 in 2 000.The top five causes of death were obstetric hemorrhage,hypertensive disorder complicating pregnancy,amniotic fluid embolism,pregnancy complicated with heart disease,pregnancy complicated with liver disease.The top five causes of death in city were obstetric hemorrhage,amniotic fluid embolism,pulmonary embolism,hypertensive disorder complicating pregnancy,pregnancy complicated with heart disease.The top five causes of death in rural were obstetric hemorrhage,amniotic fluid embolism,pulmonary embolism,hypertensive disorder complicating pregnancy,pregnancy complicated with heart disease.807 of 1 077(74.93%) were avoidable deaths and 270 of 1 077(25.07%) were unavoidable deaths.Conclusion:The maternal death is closely related with maternal health services,educational level,economic income level in Henan province.
Amniotic fluid embolism
Maternal death
Standardized mortality ratio
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Objective: To explore the effects of amniotic fluid embolism on coagulation of pregnant goat.Methods: Sixteen clinical normal,healthy,pregnant goats( Capra hircus) in the last one third of pregnancy were divided into four groups at random( n = 4 for each group) : raw amniotic fluid group( AF group),filtered amniotic fluid group( FAF group),meconium stained amniotic fluid group( MAF group),or control group( NS group).Blood samples were taken from a femoral vein before infusion( baseline),and 30 min,90 min,180 min after infusion of amniotic fluid for FBG,PLT,PT,PTI,Hb measurement.Results: No significant changes were shown for FBG,PLT,PT,PTI,Hb level in NS group.Prolonged PT,increased PLT,lower Fbg and PTI were observed in AF,FAF and MAF group,compared to the control group( P0. 05).The changes of the indexes were greater in MAF group; there was no significant difference on the Hb level between pre-operation and post-operation,or among these different groups( P0. 05).Conclusions: Amniotic fluid can activate coagulation.The changes mainly contain FBG consumption,PLT aggregation,PT prolongation in early DIC in amniotic fluid embolism.
Amniotic fluid embolism
Group B
Group A
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Objective to study the cause and risk fact leading to maternal death of pregnant woman due to illegal medical practice, discuss appropriate ways to avoid the death. Method we reviewed 11 cases related to maternal death referred for autopsy to our department from 2001-2005, all the decedents listed here were analyzed as to maternal pregnant condition, medical intervention and the cause of death. Results the most common cause of pregnancy related maternal death in our study were postpartum hemorrhage (PPH), amniotic fluid embolism (AFE), laceration of birth canal; the mostly encountered risk facts leading to the death in our study were lacking necessary antenatal care, delivering in a poor situation (mostly without qualified physicians and midwives, lacking emergency rescue service), being treated with oxytocin inappropriately or other destructive operation to facilitate delivery.
Amniotic fluid embolism
Maternal death
Neonatal death
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Amniotic fluid embolism
Thromboplastin
Blood plasma
Interstitial fluid
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Objective To identify the risk factors and preventions of maternal death caused by amniotic fluid embolism (AFE).Methods Retrospective analysis was used to analyze clinical data of maternal deaths from 1996 to 2010 in Beijing.Results In the past 15 years, maternal death caused by AFE was accounting for 19.20% of the total maternal death in Beijing. AFE was the first cause of maternal death. Average mortality of maternal death caused by AFE was 3.99 per 100 000. Compared with the first two stages, the average mortality of maternal death caused by AFE was significantly decreased from 2006 to 2010. The top five reasons of AFE were using oxytocin, premature rupture of membrane, pluripara, elderly parturient and cesarean-section.Conclusions During the past 15 years, the maternal death caused by AFE is decreased overall, however, it is still the first cause of maternal death. Stricting oxytocin usage, reducing intervention during delivery and standardizing prenatal examinations are important measurements to decrease maternal mortality caused by AFE.
Amniotic fluid embolism
Maternal death
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Amniotic fluid embolism
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Amniotic fluid embolism
Maternal death
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Objective To determine whether tissue factor(TF) is present in the amniotic fluid of normal term pregnancy. Methods Tissue factor antigen levels in amniotic fluid, blood plasma, centrifugal supernatant and sediment of 16 normal term pregnancies were detected with immunoenzymatic method(ELISA). Results Tissue factor antigen levels in the blood plasma, the whole amniotic fluid, the centrifugal supernatant and the sediment were [(31±9) ng/L0, [(404±186) ng/L], [(348±177) ng/L] and [(1360±639) ng/L], respectively. Tissue factor antigen concentrations in three states of the amniotic sediment(P0.001). Conclusions (1)High concentration of tissue factor antigen is present in the amniotic fluid of normal term pregnancy. (2) The concentration of tissue factor antigen of the cell-enriched amniotic sediment is the highest in the whole amniotic fluid. (3)Tissue factor in the amniotic fluid may be the trigger of disseminated intravascular coagulation(DIC) of amniotic fluid embolism.
Amniotic fluid embolism
Thromboplastin
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Amniotic fluid embolism
Maternal death
HELLP syndrome
Maternal mortality rate
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Objective To study the significance of keratin 16 in forensic,replicate the animal models of amniotic fluid embolism after injecting the different nature and doses amniotic fluid.Methods The Wistar female rats were randomly divided into 3 groups,there was the amniotic liquid group(AF),the mixture of amniotic fluid meconium group(MAF) and the control group(NS),and different doses of amniotic fluid were injected.The expression of keratin 16 was observed by the HE staining and immunohistochemical staining after the rats dying.Results The expression of cytokeratin 16 was negative in the control group,was positive in AF group and MAF group,and the numbers of keratin 16 expression increased when increasing amniotic fluid.Conclusions The expression of cytokeratin 16 relevants with the amniotic fluid into the blood,not relevant with the level of meconium-stained amniotic fluid.
Amniotic fluid embolism
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