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. 2021 Aug 20:11:e2021311.
doi: 10.4322/acr.2021.311. eCollection 2021.

Amniotic fluid embolism: lessons for rapid recognition and intervention

Larry Nichols  1 , Rema Elmostafa  1 , Angela Nguyen  1 , Keisha R Callins  1
Affiliations

Amniotic fluid embolism: lessons for rapid recognition and intervention

Larry Nichols et al. Autops Case Rep. .

Abstract

Amniotic fluid embolism is a rare, often fatal complication of labor and delivery. The classic presentation is the sudden onset of a triad of clinical manifestations: hypoxia, hypotension and coagulopathy. Understanding of the syndrome as an immunologically mediated, complicated and often catastrophic maternal response to fetal or placental antigens is coming into focus. New treatments such as extracorporeal membrane oxygenation (ECMO) and better use of old treatments such as transfusion offer hope, but the condition is often rapidly fatal, so saving the maternal and fetal lives depends on rapid recognition of the syndrome. This series of three cases illustrates the clinical features enabling the rapid recognition needed for successful treatment of amniotic fluid embolism syndrome.

Keywords: Amniotic fluid embolism; Autopsy; Extracorporeal membrane oxygenation; Maternal mortality.

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Conflict of interest statement

Conflict of interest: The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1. Microscopic examination revealed flat squamous cells in the lumens of small pulmonary blood vessels (H&E, 100X).
Figure 2
Figure 2. Microscopic examination revealed small calcifications (indicated by the arrow) in addition to flat squamous cells in the lumens of small pulmonary blood vessels (H&E, 100X).
Figure 3
Figure 3. Immunohistochemical staining for cytokeratin AE3 confirmed the epithelial nature of the flattened squamous cells in the small pulmonary blood vessels (100X).
See this image and copyright information in PMC

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