The diagnosis is based on several categories of clinical symptoms and signs and a careful clinical history. Since the coining of the term ‘AFE’ 76-91 years ago by Meyer JR, Steiner PE and Lushbaugh CC, several investigators have tried to establish a clinically applicable criteria or definition. A case of AFE was defined either as a clinical diagnosis or as a post mortem diagnosis (presence of foetal or amniotic fluid components in the pulmonary circulation). ![]() The clinical presentation commonly includes: acute hypotension or cardiac arrest, acute hypoxia (dyspnea, cyanosis or respiratory arrest) and coagulopathy (intravascular coagulation or severe haemorrhage), which usually occur during labour or caesarean section. Īmniotic fluid embolism is a life-threatening obstetric emergencies that arises in 2 to 8 of every 100,000 deliveries, with a mortality of 11% to 44%. The analysis from the Japanese autopsy registry showed that the three major causes of maternal death could be AFE, Disseminated Intravascular Coagulation (DIC) and brain disease. The maternal mortality rate was 8.8 in 1992 and 4.0 per 100 000 births in 2012, respectively. ![]() Cardiovascular diseases and stroke were the two leading indirect causes of maternal death. In Japan, Massive Obstetric Haemorrhage (MOH) (23%), resulting from the failure of normal obstetrical, surgical and/or systemic haemostasis, followed by brain disease (16%) and Amniotic Fluid Embolism (AFE) (12%) were the three main direct causes of maternal death in Japan. Maternal mortality is mostly due to direct and indirect maternal disorders.
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