Monday, April 4, 2011

Q: Is Amniotic fluid embolism (AFE) a anaphylactoid reaction?

Answer: Yes

Amniotic fluid embolism (AFE) is a misnomer as clinical picture is more or less like acute collapse from pulmonary embolism but in fact it is an allergic type reaction. Amniotic fluid embolism (AFE) is a rare obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enters the mother's blood stream and triggers an allergic reaction - which results in cardiorespiratory collapse. Another hallmark of the disease is severe coagulopathy.

Diagnosis: In a patient who is suspected of having AFE, a sample should be obtained by aspiration of the distal port of a pulmonary artery catheter. If sample contains fetal squamous cells it is highly suggestive of AFE syndrome - but does not completely rule in or rule out other causes too.

Treatment: Immediate delivery of baby. Support coagulopathy and hemodynamics as per standard.

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