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Re: AMNIOTIC FLUID EMBOLISMFrom: AnnMarie (anonymous@obgyn.net)Fri, 10 Oct 1997 09:40:14 +0000
> Lisa- > > First of all, congratulations on surviving this traumatic situation. The > fact that both you and your baby are doing well is truly exceptional, as > about 6 out of 10 women who have this rare complication of pregnancy > die. Unfortunately, many of the few survivors suffer long-term > neurologic defects similar to patients who have had a stroke. Many > babies die, also. (Although we may consider death during pregnancy rare > in the U.S., 500,000 women a year die worldwide during pregnancy or > childbirth). > > Amniotic fluid embolism occurs in somewhere between 1 in 8,000 to 1 in > 80,000 pregnancies, and develops when amniotic fluid (the water bag) > enters the blood vessels of the uterus and travels rapidly to the heart > and lungs. Tiny little "clots" of amniotic fluid and other cells plug > up the blood vessels in the lungs and cause massive respiratory distress > and perhaps seizures and cardiac failure. The amniotic fluid, or > something produced in response to it, affects the cells in the blood > stream and the blood cannot clot, producing DIC. Many women end up in a > coma, but some, like yourself, survive and do fine. > > Amniotic fluid embolism is a pure case of "bad luck" and is not caused > by any intervention, test, or procedure. It is one of those things, > like lightning strikes or encephalitis from a mosquito bite, that "just > happen." In the past we thought that oxytocin (pitocin) administration > may be related, but this is untrue. In our society malpractice lawyers > would have us believe that these situations must be because of someone's > fault, but, again, they are unpreventable tragedies. > > Treatment consists of rapidly delivering the baby (usually by > c/section), initiation of CPR for the mother, blood transfusion, and a > lot of prayer. Blood products, sometimes in excess of 100 units of > blood, are necessary. I have had 2 cases of this. The last one, less > than a year ago, resulted in so much blood on the operating room floor > that it was producing waves as people walked through it. I threw away > my shoes, socks, scrubs, and underwear, as all were soaked with blood. > One minute the lady was calmly going through labor, the next she was > dead. We effectively revived her (twice) and after an emergency > hysterectomy and some time in a coma she survived. Both she and her > baby are doing great. I distinctly remember putting stitches in as fast > as I could, as blood went everywhere, and saying "please, God, don't let > this lady die." These events are extremely traumatic for the doctors and > nurses caring for the patient, also, as we want nothing more than for > both mother and baby to be healthy. > > I doubt they recur in subsequent pregnancies, but I have never read a > medical paper on recurrent AFE. > > I am extraordinarily happy to hear that you and your baby are doing > well. I hope that this brief summary of AFE has answered your > questions. > > -- > Ashley Hill > D. Ashley Hill, M.D. > Associate Director > Department of Obstetrics and Gynecology > Florida Hospital Family Practice Residency > Orlando, FL > I apologize, but I am unable to answer personal e-mail > due to time constraints. > Dr. Hill, you sound like such a warm, caring doctor, and very sweet. I enjoy reading this type of post. Not only is it very informative, but it also reminds us how compassionate our caregivers really are. AnnMarie
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