Amniotic Fluids Embolism

 Amniotic Fluids Embolism 

This is an obstetric emergency with 80% mortality rate. It usually occurs toward the end of 1st stage of labour that has apparently been normal.

 

It  is  characterized  by  rapid  strong  tumultuous  contractions.

 

Membranes are usually ruptured.

 

Predisposing factors

1.           Administration of oxytocin

 

2.           Over 35 years of age.

 

Pathophysiology

 

Amniotic fluid which is high in thromboplastin is forced into the maternal circulation via the utero- placenta site and give rise to blood coagulation disorders e.g. hypofibrin- ogenaemia.

 

Sign and Symptoms

 

·              Respiratory distress of sudden onset, severe dyspnoea. Sudden collapse Cyanosis

 

·              Pulmonary oedema ,Hypotension,Trachycardia.

 

Treatment

·              Give Oxygen

 

·              Aminophylline is given slowly to reduce bronchia spasm.

 

·              Anesthesia to damp titanic uterine contraction.

 

·              Fresh blood transfusion slowly.

 

·              Forceps delivery.

 

·              Rectify clotting defect to prevent uncontrollable APH.