Amniotic fluid embolism: antepartum, intrapartum and demographic factors. (May 2015)

• Record Type: Journal Article
• Authors: Fong, Alex; Chau, Cindy T.; Pan, Deyu; Ogunyemi, Dotun A.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 28:Number 7(2015)
• Page Start: 793
• Page End: 798
• Publication Date: 2015-05
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2014.932766
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: To describe the incidence, antepartum, intrapartum and postpartum risk factors, and mortality rate of amniotic fluid embolism (AFE).</p> <p> <italic>Methods</italic>: We used 2001–2007 California health discharge data to identify cases of AFE by ICD-9 codes.</p> <p> <italic>Results</italic>: Of 3 556 567 deliveries during the time period, we identified 182 cases of AFE, resulting in a population incidence of 5.1 in 100 000. Twenty-four of the cases resulted in death, giving a case fatality rate of 13.2%. Non-Hispanic blacks had a higher than 2-fold odds of developing AFE. AFE increased significantly with maternal age, most significantly after age 39. Cardiac disease had a nearly 70-fold higher association with AFE, cerebrovascular disorders had a 25-fold higher association, while conditions such as eclampsia, renal disease, placenta previa and polyhydramnios had nearly 7- to 13-fold higher associations. Classical cesarean delivery, abruption placentae, dilation and curettage, and amnioinfusion were all procedures highly associated with AFE.</p> <p> <italic>Conclusion</italic>: Several antepartum and peripartum conditions and procedures are associated with significantly higher risks of amniotic fluid embolism. This information may contribute to a better understanding of the pathophysiology of AFE and potentially help identify those at the highest risk of developing this morbid condition.</p> </abstract>