Novel Insights from Clinical Practice
Amniotic Fluid Embolism: A Rare Complication of Second-Trimester AmniocentesisDrukker L.a · Sela H.Y.a · Ioscovich A.b · Samueloff A.a · Grisaru-Granovsky S.a
Departments of aObstetrics and Gynecology, and bAnesthesiology, Shaare Zedek Medical Center, affiliated with the Hebrew University Medical School, Jerusalem, Israel
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Amniotic fluid embolism occurring following diagnostic amniocentesis is extremely rare. Only 2 cases have been reported in the English literature over the past 55 years, the most recent one approximately 3 decades ago. We present a case of amniocentesis at 24 weeks' gestation that was performed as part of an evaluation of abnormal fetal ultrasound findings. Immediately following amniotic fluid aspiration, maternal hemodynamic collapse occurred, initially diagnosed and treated as anaphylactic shock. Shortly after initial therapy, coagulopathy was noted and amniotic fluid syndrome suspected. Rapid response restored maternal hemodynamic stability; however, the fetus had suffered fatal damage.
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Conde-Agudelo A, Romero R: Amniotic fluid embolism: an evidence-based review. Am J Obstet Gynecol 2009;20:445.e1-13.
Society for Maternal-Fetal Medicine (SMFM); Pacheco LD, Saade G, Hankins GD, Clark SL: Amniotic fluid embolism: diagnosis and management. Am J Obstet Gynecol 2016, E-pub ahead of print.
Clark SL: Amniotic fluid embolism. Obstet Gynecol 2014;123:337-348.
American College of Obstetricians and Gynecologists: ACOG Practice Bulletin No. 88, December 2007. Invasive prenatal testing for aneuploidy. Obstet Gynecol 2007;110:1459-1467.
Dodgson J, Martin J, Boswell J, Goodall HB, Smith R: Probable amniotic fluid embolism precipitated by amniocentesis and treated by exchange transfusion. Br Med J (Clin Res Ed) 1987;294:1322-1323.
Hasaart TH, Essed GG: Amniotic fluid embolism after transabdominal amniocentesis. Eur J Obstet Gynecol Reprod Biol 1983;16:25-30.
Pri-Paz S, Khalek N, Fuchs KM, Simpson LL: Maximal amniotic fluid index as a prognostic factor in pregnancies complicated by polyhydramnios. Ultrasound Obstet Gynecol 2012;39:648-653.
American College of Obstetricians and Gynecologists: Practice Bulletin No. 160: premature rupture of membranes. Obstet Gynecol 2016;127:e39-e51.
Collins NF, Bloor M, McDonnell NJ: Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism. Int J Obstet Anesth 2013;22:71-76.
Annecke T, Geisenberger T, Kürzl R, Penning R, Heindl B: Algorithm-based coagulation management of catastrophic amniotic fluid embolism. Blood Coagul Fibrinolysis 2010;21:95-100.
Bell JA, Pearn JH, Wilson BH, Ansford AJ: Prenatal cytogenetic diagnosis - a current audit. A review of 2000 cases of prenatal cytogenetic diagnoses after amniocentesis, and comparisons with early experience. Med J Aust 1987;146:12-15.
Tabor A, Philip J, Madsen M, Bang J, Obel EB, Nørgaard-Pedersen B: Randomised controlled trial of genetic amniocentesis in 4,606 low-risk women. Lancet 1986;1:1287-1293.
Giorlandino C, Cignini P, Cini M, Brizzi C, Carcioppolo O, Milite V, Coco C, Gentili P, Mangiafico L, Mesoraca A, Bizzoco D, Gabrielli I, Mobili L: Antibiotic prophylaxis before second-trimester genetic amniocentesis (APGA): a single-centre open randomised controlled trial. Prenat Diagn 2009;29:606-612.
Fairweather DV, Walker W: Obstetrical considerations in the routine use of amniocentesis in immunized RH negative women. J Obstet Gynaecol Br Commonw 1964;71:48-53.
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