PDF(Pubmed)
Abstract：
(1) Background: A rare and unexpected consequence of childbirth, labor, or the immediate postpartum period is amniotic fluid embolism (AFE). This study aims to identify AFE cases during or immediately after birth from anesthetic management perspectives. Secondary goals include assessing patient clinical features, obstetric care techniques, birth outcomes, and case survival. (2) Methods: A retrospective observational study assessed AFE patients hospitalized in three Romanian clinical institutions from October 2007 to April 2023. Based on the Society of Maternal-Fetal Medicine (SMFM) criteria, we diagnosed 11 AFE patients. (3) Results: AFE occurred in eight cases (73%) during peripartum, two (18%) within 30 min after placental delivery, and 1 (9%) during a scheduled cesarean surgery. Only one of six cardiorespiratory arrest patients responded to external cardiac massage, while the other five (83%) needed defibrillation. The patients received, on average, five units of red blood cells, six of fresh frozen plasma, and two of activated platelets. Six patients (55%) received factor VIIa infusions. Maternal mortality was 36.3%. Six neonates (75%) needed neonatal resuscitation, and two (25%) died on the second and third days. (4) Conclusions: AFE management necessitates a multidisciplinary approach and the incorporation of advanced life support techniques to optimize outcomes for both the mother and newborn.
摘要：
（1）背景：分娩的一种罕见且意想不到的后果，劳动,或产后期是羊水栓塞（AFE）。这项研究旨在从麻醉管理的角度识别出生期间或出生后立即发生的AFE病例。次要目标包括评估患者的临床特征，产科护理技术，出生结果,和案例生存。（2）方法：回顾性观察研究评估了2007年10月至2023年4月在三个罗马尼亚临床机构住院的AFE患者。根据母胎医学协会（SMFM）标准，我们诊断了11例AFE患者。(3)结果:围产期发生AFE8例(73%),两个（18％）在胎盘分娩后30分钟内，和1（9％）在预定的剖宫产手术中。六名心肺骤停患者中只有一名对外部心脏按摩有反应，而其他5人(83%)需要除颤。病人收到的，平均而言,五个单位的红细胞,六个新鲜的冷冻血浆，和两个活化的血小板。六名患者（55％）接受了VIIa因子输注。产妇死亡率为36.3%。六名新生儿(75%)需要新生儿复苏，2人（25%）在第二天和第三天死亡。（4）结论：AFE管理需要采用多学科方法，并结合先进的生命支持技术来优化母亲和新生儿的结局。
