The article on Obstetric emergencies(1) highlights the bad prognosis
for women with Amniotic Fluid Embolism. Whilst they mention treatment
with steroids, plasma expansion and delivery there is little evidence to
suggest whether this can improve outcome. There is now a national
register of cases, which has been running for nearly two years with the
intention of trying to look at the different treatments used and trying to
compare survivors with deaths. The register is detailed in the
Confidential Enquiries into Maternal Deaths "Why Mothers Die"(2). The
criteria for diagnosis and inclusion into the register are
- Acute hypotension or cardiac arrest
- Acute hypoxia (dyspnoea, cyanosis or respiratory arrest)
- Coagulopathy (laboratory evidence of intravascular coagulation or severe
haemorrhage)
- Onset of all of the above during labour, Caesarean section or within 30
minutes of delivery.
- No other clinical condition or potential explanation for the symptoms
and signs.
If there are any suspected or confirmed cases they should be reported
to me via my secretary on 01274-364520.
To date, 16 cases have been reported from 1997 and 1998 and four
maternal deaths - a mortality of 25%. Obviously the dataset is too small
at the moment to get any clear information so the reporting of further
cases is very important.
Rapid Response:
AMniotic Fluid Embolism Register
AMNIOTIC FLUID EMBOLISM REGISTER
The article on Obstetric emergencies(1) highlights the bad prognosis for women with Amniotic Fluid Embolism. Whilst they mention treatment with steroids, plasma expansion and delivery there is little evidence to suggest whether this can improve outcome. There is now a national register of cases, which has been running for nearly two years with the intention of trying to look at the different treatments used and trying to compare survivors with deaths. The register is detailed in the Confidential Enquiries into Maternal Deaths "Why Mothers Die"(2). The criteria for diagnosis and inclusion into the register are
- Acute hypotension or cardiac arrest - Acute hypoxia (dyspnoea, cyanosis or respiratory arrest) - Coagulopathy (laboratory evidence of intravascular coagulation or severe haemorrhage) - Onset of all of the above during labour, Caesarean section or within 30 minutes of delivery. - No other clinical condition or potential explanation for the symptoms and signs.
If there are any suspected or confirmed cases they should be reported to me via my secretary on 01274-364520.
To date, 16 cases have been reported from 1997 and 1998 and four maternal deaths - a mortality of 25%. Obviously the dataset is too small at the moment to get any clear information so the reporting of further cases is very important.
Competing interests: No competing interests