AMNIOTIC FLUID EMBOLISM

Click to edit Master MERLIN ASHLY M.S subtitle style 2 ND YR MS.c nsg

DEFINITION
n

It is an obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enters the mother's blood stream via the placental bed of the uterus and triggers an allergic reaction resulting in cardiorespiratory (heart and lung) collapse and coagulopathy

ETIOLOGY Abdominal trauma Amniocentesis Advanced maternal age Caesarean section Instrumental vaginal delivery Polyhydramnios Uterine rupture Placenta previa

Cont.
n n n n n n n

Abruptio placenta Eclampsia Macrosomic fetus Precipitated labour Insertion of intra uterine pressure catheter Injudicious administration of oxytocin Intra uterine hypertonic saline administration ( abortion)

PATHOPHYSIOLOGY
n

n n

Fetal cells vernix caseosa and amniotic fluid enters maternal circulation Anaphylactic reaction to fetal antigens Mast cell degranulation and release of hystamine Debris lodge in blood vessels of lungs

Cont
n

Alveolar haemorrhage and pulmonary hypertension Reduction of blood flow to left side of heart Decreased cardiac ouput and peripheral vascular collapse Pulmonary hypertension, corepulmonale, pulmonary edema and congestive heart failure

Cont
n

Derangement of ventilation perfusion range cause tissue hypoxia Thromboplastic activity of amniotic fluid causes dfisseminated deposition of fibrin clots Afribigenomia, and DIC

CLINICAL FEATURES
n n n n n n n

Hypotension Dyspnea and tachypnea Seizures-tonic clonic seizures Cyanosis Fetal bradycardia Tachycardia, arrhythmia Shivering , sweating and anxiety

CLINICAL FEATURES

DIAGNOSIS
n n n n n n n n n

History collection ABG levels -decreased PH level,<7.4 -decreased PO2 level, <80 mm of hg - decreased PCO2 level Prolonged prothrombin time Shortende thromboplastin time Increased CVP Chest X RAY

MANAGEMENT
n n n

n n n

Resuscitation measures Oxygen administration Mechanical ventilation with high inspired fraction of oxygen Trendlenberg position ECG monitoring Pulmonary catheter and CVP monitoring

MANAGEMENT
n

n n

Volume replacement with isotonic crystalloid solution Uterine massage to control bleeding Blood transfusion and administering blood products Intravenous steroid to reduce anaphylactic and inflammatory reactions

MANAGEMENT
n n n n n

PHARMACOLOGICAL METHOD Dopamine Digitalization Isoproterenol Hydrocorticosterone

MANAGEMENT
n n n n n n

Diuretics Indomethacin IVF Ringer lactate Sodium bi carbonate administration Methylergovine Iv Uterine artery embolisation

THANK YOU

FlashDemo Software
FlashPoint
PowerPoint to Flash Converter

$59

Accurately transfers PowerPoint animation effects, slide transitions, embedded Flash movies, audio, and video to an extremely compact Flash movie. Easy and fast. Works fine with PowerPoint 2007 and its new *. pptx *. ppsx file formats. The Flash movie can be easily published on a website or delivered by e-mail. Specially designed for users with PowerPoint knowledge. Buy Now

FlashDemo Studio

Screen Recorder

FlashDemo Studio captures all screen activity from your Windows Desktop in real time and publishes as a Flash movie. Perfect for creating online tutorial, training & support videos, E-Learning material. Easily reach the widest possible audience by placing lectures, presentations and demonstrations online.

$99

Buy Now

http://www.FlashDemo.net