Anaphylactoid Syndrome Of Pregnancy Research Articles

Sudden onset of syncope and disseminated intravascular coagulation at 14 weeks of pregnancy: a case report

BackgroundAmniotic fluid embolism (AFE), also known as anaphylactoid syndrome of pregnancy (ASP), typically occurs during labor and may result in cardiorespiratory collapse and disseminated intravascular coagulation (DIC). There are reports describing less typical presentations of AFE/ASP in which patients do not necessarily have the classic triad of hypoxia, hypotension, and coagulopathy. AFE/ASP rarely occurs in the absence of labor, but such cases may involve medical or surgical abortion, spontaneous miscarriage, or obstetrical procedures including amniocentesis and amnioinfusion. There are, however, no previously reported cases of AFE/ASP with sudden loss of consciousness and disseminated intravascular coagulation occurring during early pregnancy, in the absence of any intervention or obstetric event.Case presentationA 32-year-old G3P2 Japanese woman had sudden-onset syncope at 14 weeks’ gestation. On arrival at our hospital, her level of consciousness was severely disturbed as determined by the Glasgow Coma Scale. Although her vital signs were initially stable, blood samples collected intravenously and by femoral artery puncture did not coagulate. A subchorionic hematoma with active extravasation of blood was apparent on contrast-enhanced computed tomography. Two hours after her arrival, she developed hypovolemic shock with progression of DIC, presumably due to intrauterine and retroperitoneal bleeding. After transfusion of blood products; treatments for DIC including the use of recombinant human soluble thrombomodulin, ulinastatin, and corticosteroids; and hysterectomy, her level of consciousness and physical condition improved remarkably. Later investigation of preoperative blood samples revealed that serum levels of AFE/ASP-associated markers were elevated. Immunohistochemical studies on the excised, unruptured uterus showed that amniotic fluid components were present inside a uterine blood vessel.ConclusionsThis is the first reported patient with sudden-onset syncope and DIC, but without apparent cardiorespiratory collapse, with the highly likely etiology of AFE/ASP occurring at the beginning of the second trimester of pregnancy and in the absence of intervention or delivery. Maternal collapse with DIC during any stage of pregnancy should be considered an AFE/ASP-associated event, even in the absence of labor or obstetric procedures. This event may occur in the presence of subchorionic hematoma alone.

A Case Report of Cardio-Respiratory Arrest Suspected of Amniotic Fluid Embolism (Anaphylactoid Syndrome of Pregnancy)

A Case Report of Cardio-Respiratory Arrest Suspected of Amniotic Fluid Embolism (Anaphylactoid Syndrome of Pregnancy)

Disseminated intravascular coagulation in perinatal medicine

Introduction. Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by intravascular activation of blood clotting without specific localization and arising from various causes. DIC is the most complex and high-priority problem in contemporary clinical medicine including obstetrics and perinatology. DIC significance is related to its peak perinatal mortality, as well as a large rate of complications during childbirth and postpartum period. Aim: to conduct comprehensive data assessment related to DIC pathogenesis and management in pregnant women and newborns. Materials and methods . A search for DIC-related publications within the past 10 years was conducted in international research databases: Scientific Electronic Library Online eLibrary, Google Scholar, ScienceDirect, Cochrane Library, PubMed/Medline. The data regarding DIC diagnostic criteria and markers, as well as current approach to its treatment are presented. Results. DIC may be considered as one of the causes resulting in massive obstetric bleeding. The majority of pregnancy-related complications is manifested as preeclampsia, premature detachment of normally situated placenta and anaphylactoid syndrome of pregnancy. Any massive bleeding should be perceived as hemorrhage resulting from the DIC progression. Conclusion. Knowledge of the DIC pathogenetic mechanisms is necessary for conducting a differential diagnosis and applying timely treatment.

Анафилактоидный синдром беременности и нарушение системы гемостаза

Анафилактоидный синдром беременности и нарушение системы гемостаза

Anaphylactoid Syndrome of Pregnancy

Anaphylactoid syndrome of pregnancy (ASP) is a widespread, proinflammatory, anaphylactic-like reaction that can occur when amniotic fluid enters the maternal blood circulation. ASP is characterized by four cardinal findings: respiratory distress, altered mental status, hypotension, and disseminated intravascular coagulation. ASP is commonly associated with maternal and neonatal mortality. Early recognition followed by prompt and aggressive treatment can improve survival rates and are among the most critical activities for nurses and other clinicians caring for women with ASP.

Amniotic Fluid Embolism

Amniotic fluid embolism remains a devastating and incompletely understood phenomenon of acute cardiopulmonary collapse and coagulopathy in labor and immediate postpartum period not explained by other diagnoses. It is rare in the general population but is a relatively frequent cause of maternal death and long-term neurologic deficit. Diagnosis should rely on the presence of classic clinical findings and not histopathologic findings of squamous cells in the vasculature of the deceased. Management relies on quick and aggressive support measures and advanced cardiac life support in cases of cardiac arrest. Coagulopathy and hemorrhage is best managed with massive transfusion protocols. This review contains 6 figures, 5 tables and 65 references Key Words: amniotic fluid, amniotic fluid embolism, anaphylactoid syndrome of pregnancy, disseminated intravascular coagulopathy; massive transfusion, maternal cardiac arrest, obstetric hemorrhage, pregnancy, pulmonary embolism, respiratory distress

Surviving Anaphylactoid Syndrome of Pregnancy: A Case Study

Anaphylactoid Syndrome of Pregnancy (ASP) is a rare complication of delivery in mother and/or infant during the process of birth. Known as either Anaphylactoid Syndrome of Pregnancy or Amniotic Fluid Embolism, the maternal mortality rate worldwide for this complication is between 10 and 16% while the fetal mortality rate is upwards of 30%. The majority of maternal survivors are expected to have long - term neurologic deficit. While the majority of infants will survive, the majority will also incur some form of neurologic defect. This report is of a case in which both the mother and infant survived with discharge occurring at eleven days for the mother and eighteen days for the infant.

Aortic Compression and Cross Clamping in a Case of Placenta Percreta and Amniotic Fluid Embolism: A Case Report

Amniotic fluid embolism (AFE, also known as anaphylactoid syndrome of pregnancy) at the time of surgery for placenta percreta has been previously reported. We report here a case in which AFE and associated cardiac arrest occurred following a hysterectomy for placenta percreta. In this case, subhepatic manual aortic compression during the cardiac arrest and chest compressions followed by infrarenal aortic cross-clamping during volume infusion and reversal of the coagulopathy were associated with a successful resuscitation and good maternal outcome.

Strip of the Month: February 2011

Strip of the Month: February 2011

Anaphylactoid Syndrome After Intrauterine Pressure Catheter Placement

Anaphylactoid syndrome of pregnancy is a rare and poorly understood complication of pregnancy. Intrauterine pressure catheter placement is a procedure routinely performed in labor and delivery that is traditionally associated with few complications. A pregnant woman at term experienced anaphylactoid syndrome of pregnancy associated with cardiopulmonary failure, disseminated intravascular coagulation, and neurologic sequelae immediately after the placement of an intrauterine pressure catheter. Ultimately, the patient returned to a near-normal level of function, whereas the infant died of pneumonia at 10 months of age. Anaphylactoid syndrome of pregnancy is a rare complication of intrauterine pressure catheter placement. It is important to be prepared for unexpected emergencies, even with such a routine procedure.

Anaphylactoid Syndrome of Pregnancy Immediately After Intrauterine Pressure Catheter Placement

A 35-year-old multipara woman underwent intrauterine pressure catheter placement during labor. Immediately afterwards, she had severe dyspnea develop, became unresponsive, and had a prolonged fetal bradycardia. During emergency cesarean section, she required cardiopulmonary resuscitation repetitively. She then had disseminated intravascular coagulopathy develop and underwent hysterectomy. Anaphylactic reaction may be associated with intrauterine pressure catheter placement.

Anaphylactoid syndrome of pregnancy immediately after intrauterine pressure catheter placement

A 35-year-old multipara woman underwent intrauterine pressure catheter placement during labor. Immediately afterwards, she had severe dyspnea develop, became unresponsive, and had a prolonged fetal bradycardia. During emergency cesarean section, she required cardiopulmonary resuscitation repetitively. She then had disseminated intravascular coagulopathy develop and underwent hysterectomy. Anaphylactic reaction may be associated with intrauterine pressure catheter placement.

Amniotic fluid embolism managed with success during labour: report of a severe clinical case and review of literature

AFE (amniotic fluid embolism) is widely known as a disastrous rapid-progressing clinical entity. The incident ranges from 1:800 to 1:8,000. The mortality rate reaches 61-86%. Neonatal survival is reported at 70%. We describe the case of a healthy 29-year old primigravida developing amniotic fluid embolism during labour. Acute respiratory failure and hypotension combined with seizures were the initial symptoms. The patient under went an urgent caesarean section with extreme blood loss, complicated by disseminated coagulopathy. A total hysterectomy was performed due to profuse bleeding. Aggressive management was practiced with continuous transfusion of blood products and administration of vasocopressors. Amniotic fluid embolism or anaphylactoid syndrome of pregnancy is a life-threatening condition. Diagnosis is one of the exclusion. Its management is very difficult and requires quick management and cooperation of physicians from different specialties.

Aprotinin in the Management of Coagulopathy Associated with Amniotic Fluid Embolus

Amniotic fluid embolus, also known as anaphylactoid syndrome of pregnancy is a rare complication of pregnancy. When it occurs, the maternal mortality rate may be as high as 86%, and in survivors, the morbidity rate may be just as high. Hallmark clinical features include maternal cardiovascular collapse with disseminated intravascular coagulation, and fetal distress. Management centers on strategies to improve oxygenation, support circulation, and correct the coagulopathy. We report the case of a patient who developed amniotic fluid embolus and was effectively managed with aprotinin to control the coagulopathy associated with this devastating complication of pregnancy.