WOMENS-HEALTH Messages for September, 2000: Re: Amniotic Embolus and DIC

Re: Amniotic Embolus and DIC

From: William F. von Almen, II, MD, FACOG (anonymous@obgyn.net)
Sun, 3 Sep 2000 09:00:56 -0500 (CDT)

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At Sun, 3 Sep 2000, Susan wrote: >
>I worked in an OB/GYN office for 12 years and have never heard of any of
>our patients dying from amniotic embolus with DIC. I am reading that
>this is rare. My niece died 5 weeks ago from this horrible tragedy.
>Scenario: 3rd pregnancy, induced labor (she was at 40 weeks and
>uncomfortable), child delivered with apgars of 7 and 9, she coded
>approximately 15 minutes later with hemorrhaging, (was given 19 units of
>blood) had an emergency hysterectomy and bleeding was stopped, she coded
>again and never regained consiousness. All this happened in a 4 hour
>period time frame. My questions are could the induction have triggered
>this in any way? And how easy is this to diagnose on autopsy? After 5
>weeks, they still have no answers. The Pathologist says he can find no
>reason for her death at this point. Thank you for any other information
>you can provide.

Susan

I have been involved in a case like this, and hope to never be in one again (odds say I will not, thank goodness). It is a rare and largely unpreventable tragedy. It occurs when certain amounts of AF gets into the maternal bloodstream. It causes profound shock, DIC, hemorrhage and death in very short order. No one is sure how it happens, but it is postulated it occurs due to explosive labor, pushing the AF into the maternal circulation. One proposed method to diagnose it is to find fetal squamous cells in the maternal circulation, either in a blood specimen or by special pathologic stains. I am sorry for your loss.

--
William F. von Almen, II, MD, FACOG
Editorial Advisor-Pregnancy and Birth
Private Practice
New Orleans, La.

*Please understand I can not respond to private emails.

*These comments are for educational purposes only.  They are
not meant to take the place of an examination by a qualified
health care provider.  They are not intended to be the start
of a physician-patient relationship.

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