Amniotic fluid embolism: an overview and case report.

This article gives an overview of amniotic fluid embolism, which still carries a fatality rate of approximately 86% and which accounts for 9% of all maternal deaths. A case report is presented which ended with a fatal outcome. Photomicrographs show fetal squames and lanugo hairs in the pulmonary capillaries as well as ones aspirated from the right atrium. The treatment is discussed in terms of acute primary and acute secondary care. Acute primary care centers around the prompt recognition and treatment of pulmonary edema. This is apparently due to the mechanical blockade of the pulmonary vasculature and particulate matter from the amniotic fluid and also to an anaphylactoid reaction adding to the pulmonary arteriolar spasm. The acute secondary treatment deals with combating the almost inevitable disseminated intravascular coagulation and uterine atony. Being always alert to the possible occurrence of this condition and being able to institute appropriate therapy rapidly are necessary for a successful outcome.