Amniotic Embolism



Incidence

  • Rare, 1:30,000, 6% of all maternal deaths.
  • Mortality rate >85%.
  • Post-mortem diagnosis by meconium in the maternal lungs or right side of the heart.
  • Due to premature placental separation.
  • Predisposed by tumultuous contractions with rupture of membranes

Clinical

  • Sudden respiratory then cardiac arrest.
  • Unresolving cyanosis.

Management

  • Only possible if diagnosis suspected.
  • 100% O2, intubate, CPR.
  • Bloods, CVP.
  • Aspirate blood from right side of heart (senior staff )
  • Manage coagulopathy (platelets, FFP)
  • Cephradine, Metronidazole.

Content by Dr Íomhar O' Sullivan 23/06/2000. Reviewed by Dr ÍOS 12/12/2003, 12/12/2004, 01/05/2005, 30/03/2007. Last review Dr ÍOS 29/08/14.