scholarly journals Amniotic fluid embolism: the known and not known

2013 ◽  
Vol 7 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Michael D Benson
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
English Language ◽  
Anaphylactoid Reaction ◽  
Clinical Signs ◽  
Amniotic Fluid Embolism ◽  
Pulmonary Vasculature ◽  
Control Group ◽  
Fetal Antigen ◽  
Brazilian Journal

Amniotic fluid embolism was first recognized in 1926, in a Brazilian journal case report, on the basis of large amounts of fetal material in the maternal pulmonary vasculature at autopsy. The first English language description appeared in 1941 and consisted of eight parturients dying suddenly in which, once again, fetal material was seen in the pulmonary vasculature. A control group of 34 pregnant women dying of other recognized causes did not have fetal material in their lungs. The incidence of recognized, serious illness is on the order of two to eight per 100,000, with a mortality rate ranging from 13% to 35%. The diagnosis rests largely on one or more of four clinical signs: circulatory collapse, respiratory distress, coagulopathy, and seizures/ coma. The only confirmatory laboratory test remains autopsy findings although serum tests for fetal antigen, insulin-like growth factor binding protein-1, and complement are currently being investigated. One of the paradoxes of diagnosis is that fetal material in the pulmonary circulation at autopsy is specific for amniotic fluid embolism, while the same finding in the living is not. The mechanism of disease remains uncertain although the best available evidence suggests that complement activation might have a role. In contrast, mast cell degranulation probably is not a mechanism, so amniotic fluid embolism is not an anaphylaxis or anaphylactoid reaction as has been occasionally suggested. Perhaps the greatest unknown is not why 1 in 50,000 pregnant women develop what appears to be an immune response to their fetus, but rather why the other 49,999 do not?

scholarly journals Amniotic fluid embolism: Then and now

2014 ◽  
Vol 7 (1) ◽  
pp. 34-36 ◽  
Author(s):  
A Rafael ◽  
MD Benson
Keyword(s):  
Case Report ◽  
Amniotic Fluid ◽  
English Language ◽  
Amniotic Fluid Embolism ◽  
Pulmonary Vasculature ◽  
First Case

Background The first case report to describe amniotic fluid embolism that appeared in 1926 in Basil-Medico is translated from Portuguese to English. Case A patient with a dead fetus for several weeks, presented in labor and died suddenly with fetal squames evident in the maternal pulmonary vasculature at autopsy. Conclusion As can be seen from the translation, this case report is remarkably similar in many of its features to some of the eight patients described 15 years later in the first English language discussion of the disease by Steiner and Luschbaugh in JAMA. An enigma presented by this first case remains today: fetal material in the maternal pulmonary vasculature appears specific for amniotic fluid embolism at autopsy but not in living patients.

scholarly journals GENETIC ASPECTS OF PREGNANCY MISCARRIAGE

2019 ◽  
pp. 71-76
Author(s):  
K. M. Lisova ◽  
I. V. Kalinovska ◽  
O. M. Yuzko
Keyword(s):  
Pregnant Women ◽  
Molecular Genetic ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Control Group ◽  
Molecular Genetic Study ◽  
Immunological Parameters ◽  
Fetoplacental Complex ◽  
Maternal Genotype ◽  
A1166c Polymorphism

Pregnancy miscarriage is a consequence of many factors. The aim of the study was to analyze the effect of miscarriage gene on embryometric, ultrasound, hormonal, immunological parameters in pregnant women, and to evaluate its prognostic value. The main group includes 31 pregnant women who had clinical signs of miscarriage in current or previous pregnancy. The control group consists of 32 healthy pregnant women whose clinical-paraclinical parameters served as a control to compare the data of the pregnancy survey of the main surveillance group. A general clinical examination and a special obstetrical examination (complaints, anamnesis, general medical examination, obstetric examination), biochemical studies (determination of hormones of the fetoplacental complex in blood serum of pregnant women), ultrasound, immunological studies, histological studies of the placenta, molecular genetic study A1166C polymorphism of the AGTR1 gene were made. In the course of the research, the genetic determinism of miscarriage was discovered. The polymorphism of the A1166C of the AGTR1 gene was considered as a prognostic marker of miscarriage in early gestational term and preeclampsia in the second half of pregnancy. A reliable marker of abortion was the maternal genotype 1166AC for the genome AGTR1. The risk of occurrence of clinical manifestations of abortion increased five times. At simultaneous influence of all prognostic factors the risk of abortion increased 6,25 times. Detection of genetic markers of pregnancy miscarriage will allow early correction of this pathology and prevent perinatal loss.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

scholarly journals Correlation study between increased fetal movement during the third trimester and neonatal outcome

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Stress Test ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Third Trimester ◽  
The Third ◽  
Fetal Movements

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

Correction of bleeding in the early stages of gestation depending on the status of the embryo and extraembryonic structures

2017 ◽  
pp. 22-24
Author(s):  
E.V. Kravchenko ◽  
Keyword(s):  
Pregnant Women ◽  
Ultrasonic Inspection ◽  
Clinical Signs ◽  
First Trimester ◽  
Fibrin Clot ◽  
Main Group ◽  
Control Group ◽  
Early Stages ◽  
The Status ◽  
Hemostatic Therapy

The objective: the study of the status of the embryo and extraembryonic structures for bleeding that is not associated with the detachment of the chorion in the first trimester of gestation. Patients and methods. Were examined 34 patients in the gestational age 6-9 weeks (main group) with bleeding from the genital tract, in which, at the primary ultrasonic inspection revealed no detachment of the chorion. The control group included 30 women with uncomplicated course And trimester of gestation. The average age of the pregnant women of the main group was 25.3±3.1 years in the control group 26.4±4.3 years. All women underwent standard clinical and laboratory examination. Results. Studies have shown that prognostic markers of unfavorable development of the embryo in the early stages of pregnancy bleeding not related to chorion detachment was not detected. For the purpose of hemostasis in pregnant of the main group of prescribed drugs traneksamic acid 0.25 mg 3-4 times a day for 3 days. Traneksam – antifbrinolytic tool is able to block not only plasminogen, and plasmin that has already formed. It also stimulates the synthesis of collagen, through which increases the elasticity of the fibrin clot. Pregnant women in both groups received vitamin E 1 capsule per day magnesium products, Magnicum 1 tablet 3 times a day, folic acid 400 micrograms per day. Assessing clinical signs of disease in dynamics of treatment, it should be noted that the hemostasis in the main group was achieved in an average of 2.3±0.7 days. Conclusion. Bleeding in early gestation, not connected with the detachment of the chorion, the use of Traneksam provides fast absolute hemostasis, which in turn contributes to the normalization of tone of the uterus and the physiological course of placentation. Key words: bleeding in early pregnancy, the chorion detachment, hemostasis, hemostatic therapy, Traneksam.

scholarly journals 610: The evidence of anaphylactoid reaction in lung tissue affected by amniotic fluid embolism

2019 ◽  
Vol 220 (1) ◽  
pp. S404
Author(s):  
Tomoaki Oda ◽  
Naoaki Tamura ◽  
Yukiko Kohmura-Kobayashi ◽  
Naomi Furuta-Isomura ◽  
Chizuko Yaguchi ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Lung Tissue ◽  
Anaphylactoid Reaction ◽  
Amniotic Fluid Embolism

Associations between second-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α and spontaneous preterm delivery in singleton pregnancies

2019 ◽  
Vol 47 (3) ◽  
pp. 304-310 ◽  
Author(s):  
Rauf Melekoglu ◽  
Ercan Yilmaz ◽  
Osman Ciftci ◽  
Yusuf Taner Kafadar ◽  
Ebru Celik
Keyword(s):  
Preterm Birth ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Control Group ◽  
Second Trimester ◽  
Spontaneous Preterm Delivery ◽  
Tnf Α ◽  
Factor Α ◽  
Fluid Levels

Abstract Background We investigated the roles of inflammatory cytokines and the A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) family in the etiopathogenesis of spontaneous preterm delivery by comparing the ADAMTS4, ADAMTS5, interleukin (IL)-6, and tumor necrosis factor-α (TNF-α) levels in second-trimester amniotic fluid between pregnant women with preterm birth and term controls. Methods All pregnant women who underwent second-trimester amniocentesis for genetic analysis between January 1, 2016, and January 1, 2018, were enrolled in this study. From this cohort, 22 patients who subsequently experienced spontaneous preterm delivery before 34 weeks of pregnancy formed the study group, and 22 age- and body mass index (BMI)-matched patients without preterm birth constituted the control group. Results No significant differences were observed between the preterm birth and control groups in terms of age, BMI, obstetric history of preterm delivery, gestational age at amniocentesis, or indication for amniocentesis. The mean amniotic fluid levels of ADAMTS4 and ADAMTS5 were significantly increased in the preterm birth group compared to the control group (248.3±22.6 and 182.4±19.8 pg/mL, P=0.012; and 198.6±21.6 and 159.1±21.7 pg/mL, P=0.035, respectively). Significantly increased IL-6 and TNF-α levels were also detected in the amniotic fluid of women who experienced spontaneous preterm delivery, relative to controls (142.1±16.2 and 95.8±16.4 pg/mL, P<0.001; and 139.4±12.5 and 89.6±11.2 pg/mL, P<0.001, respectively). Conclusion The results of this study imply that increased mid-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α play an important role in the pathophysiology of spontaneous preterm delivery.

scholarly journals The Influence of Fasting in Summer on Amniotic Fluid During Pregnancy

2016 ◽  
Vol 6 ◽  
pp. 21
Author(s):  
Ayşegül Altunkeser ◽  
Muslu Kazım Körez
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Parameters ◽  
Fluid Volume ◽  
Control Group ◽  
Growth Data ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume ◽  
Significant Difference

Objectives: Ramadan is a holy month in which eating and drinking are forbidden from dawn to sunset. In this study, we investigated using ultrasonography (USG) whether fasting in summer (as occurred in Ramadan 2014) had an influence on the volume of amniotic fluid during pregnancy. Materials and Methods: The study included 119 pregnant women in total who were admitted to our department with a request of obstetric USG between June 28, 2014, and July 27, 2014. The fasting group included 61 pregnant women and the control group of 58 pregnant women. In our study, all the fasting pregnant women had Sahur (predawn meal eaten before starting fasting) and Iftar (the evening meal for fast-breaking) every day, regularly. The women in the control group did not fast. In addition to amniotic fluid index and fetal biometric measurements during Ramadan, amniotic fluid volume was measured ultrasonographically throughout pregnancy. All ultrasound examinations were performed at least 8 h after Sahur during Ramadan. Chi-square test was utilized to compare the measurements of amniotic fluid volume, and Mann–Whitney U-test was utilized to analyze the differences in fetal growth data. Moreover, difference was considered statistically significant when the P value was <0.05. Results: The mean age was 25.7 years in the fasting group and 25.8 years in the control group. Other characteristics and mean gestational weeks of the two groups were similar. Ultrasonographically, there was no significant difference between two groups in respect to amniotic fluid amount during pregnancy (P = 0.7). There was no significant difference with regard to fetal growth parameters either (P > 0.05). Conclusion: In pregnant women who had regular predawn and fast-breaking meals, fasting in summer did not elicit alteration in the amount of amniotic fluid throughout pregnancy.

scholarly journals Relationship of Amniotic Fluid Index (AFI) Between Maternal and Perinatal in Patients

2021 ◽  
pp. 460-465
Author(s):  
Manimekalai, Neranjana
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Bacterial Infections ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Control Group ◽  
Amniotic Fluid Index ◽  
Nicu Admission ◽  
Relationship Of

Background: Alcohol amniotic, a protecting fluid that surround the embryo. It protects from concussion, pressure, desiccation, reminiscent of the aquatic origin of life. Adequate amount of amniotic fluid is essential requirement for the normal development and it acts like a cushion against trauma, agitation and accidental impulsions. It has also bacteriostatic properties and prevents the infection of many bacterial infections. Aim: To assess the maternal and fetal outcome in cases with normal and abnormal Amniotic Fluid Index levels. Results: The mode of delivery was spontaneous vaginal delivery followed by Assisted VD, Elective CS, Emergency CS respectively. It was affected by amount of liquor since, low AFI group 35 (75%) patients ended up in cesarean section for fetal distress. While in control group 63(18.3%) patients had caesarean section. Conclusion: Early neonatal death was seen in 0.2%, 4.5% and 70.5% newborns were born to pregnant women with normal AFI, oligohydramnios respectively. 70.5% neonates born to pregnant women with oligohydramnios had NICU admission. All cases were admitted in NICU because of respiratory distress.

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