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2015, Number 5

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AMC 2015; 19 (5)

Amniotic fluid embolism: etiopathogenic realities and myths of a potentially fatal syndrome

Rodríguez GRM, Pérez SR, Roura CJO, Rodríguez PI

Language: Spanish
References: 30
Page: 528-538
PDF size: 349.66 Kb.


ABSTRACT

Background: amniotic fluid embolism is a catastrophic syndrome that takes place during the onset of labor or during the labor. This syndrome of variable incidence is the second cause of maternal death in many regions of the world. Rates up to 60 % are reported in developed countries. A more rigid investigation has greatly increased the comprehension of this condition in the last two decades.
Objective: to set out the most recent elements that try to explain the etiology and physiopathology of amniotic fluid embolism.
Method: a review o f 32 bibliographies, including journals and classic texts, w as made through the Cuban virtual library, Lilacs, PubMed and Medline.
Development: amniotic fluid embolism is, from the physiopathological point of view , similar to the systemic inflammatory response syndrome, and it is common in conditions like septic shock, in which the abnormal response of the host is the main responsible for the clinical manifestations. Bimodal theory is the rule: an early stage characterized by vasospasm and pulmonary hypertension and heart failure; and a late stage where left heart failure, pulmonary edema, shock and coagulation disorders predominate.
Conclusions: the physiopathological basis o f this sequence o f hemodynamic changes seems to entail a complex sequence of reactions that result from the abnormal activation of proinflammatory mediator systems, similar to those present in the systemic inflammatory response syndrome that follows the almost universal flow of fetal antigens to the maternal circulation during labor.


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