1.Department of Obstetric, 2 Department of Anesthesia, 3.Internal Medical Department,Beijing Obstetric and Gynecology Hospital Affiliated Capital Medical University,Beijing 100026,China
Abstract：Objective To summarize the clinical data of amniotic fluid embolism and to explore the mechanism of amniotic fluid embolism.Methods From March 2011 to November 2018, the symptoms, signs, laboratory examinations, medication treatment, maternal and fetal pregnancy outcomes and prognosis of patients with amniotic fluid embolism during late pregnancy in Beijing Obstetrics and Gynecology Hospital were retrospectively recorded.Results Among the 109401 late pregnancy delivery records in our hospital, there were 13 cases of amniotic fluid embolism, with an incidence of 11.88/100 000, 53.8% (7/13) of pregnant women over 35 years old, 53.8% (7/13) of multipartum, 4 cases of allergic history, 4 cases of high placental risk factors, and 3 cases of pregnancy-induced hypertension. 84.6% (11/13) of the patients had at least one of clinical life-threatening signs (and/or hypotension, hypoxia, DIC), 3 patients had cardiac arrest, 5 patients had DIC, and 9 patients had postpartum hemorrhage (more than 1000 ml) [1100-6000 ml, (2963±406) ml]. Among the 4 patients, 3 were positive for amniotic fluid components from blood samples, 9 were treated with large amounts of vasoactive mediaters for more than 3 hours, and 5 underwent hysterectomy without death.Conclusions Amniotic fluid embolism mainly depends on clinical manifestations for diagnosis. Typical amniotic fluid embolism is a rare and extremely dangerous delivery complication. Timely and accurate diagnosis and well-trained multidisciplinary rapid response team, instant and adequate antiallergic and vasoactive drugs and accurate life support therapy are the key measures to save the lives of patients with amniotic fluid embolism.
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