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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(07): 369-372
DOI: 10.1055/s-0037-1601428
Case Report
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Amniotic Fluid Embolism. Is a New Pregnancy Possible? Case Report

Embolia do líquido amniótico. Será uma nova gestação possível? Relato de caso
Ana Filipa Cabrita Caeiro
1   Department of Gynecology and Obstetrics, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
,
Irina Dulce Tapadinhas Matos Ramilo
1   Department of Gynecology and Obstetrics, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
,
Ana Paula Santos
1   Department of Gynecology and Obstetrics, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
,
Elizabeth Ferreira
1   Department of Gynecology and Obstetrics, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
,
Isabel Santos Batalha
1   Department of Gynecology and Obstetrics, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
› Author Affiliations
Further Information

Publication History

07 October 2016

09 January 2017

Publication Date:
02 May 2017 (online)

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Abstract

Amniotic fluid embolism (AFE) is a rare but potentially catastrophic clinical condition, characterized by a combination of signs and symptoms that reflect respiratory distress, cardiovascular collapse and disseminated intravascular coagulation (DIC). Its pathogenesis is still unclear. More recently, the traditional view of obstruction of pulmonary capillary vessels by amniotic fluid emboli as the main explanation for the etiology has been ruled out, and immunologic factors and the activation of the inflammatory cascade took on an important role. Amniotic fluid embolism has an unpredictable character, its diagnosis is exclusively clinical, and the treatment consists mainly of cardiovascular support and administration of blood products to correct the DIC. No diagnostic test is recommended until now, though multiple blood markers are currently being studied. The authors present a case report of a woman who had survived AFE in her previous pregnancy and had a subsequent pregnancy without recurrence, providing one more clinical testimony of the low risks for the pregnancy after AFE.

Resumo

A embolia do liquido amniótico (ELA) é uma situação clínica rara, mas potencialmente catastrófica, que se caracteriza por uma combinação de sinais e sintomas clínicos que refletem insuficiência respiratória aguda, colapso cardiovascular e coagulação intravascular disseminada (CID). A sua patogênese ainda não é totalmente compreendida. Mais recentemente, a visão tradicional de obstrução dos capilares pulmonares por êmbolo de líquido amniótico, como explicação principal para a etiologia desta síndrome, tem sido desconsiderada, assumindo os fatores imunológicos e a ativação das cascatas de resposta inflamatória um papel importante. A embolia do líquido amniótico tem um carácter imprevisível, e o seu diagnóstico é exclusivamente clínico, sendo o tratamento sobretudo de suporte respiratório e cardiovascular, com a concomitante administração de derivados do sangue para corrigir a CID. Nenhum teste de diagnóstico é recomendado até o momento, embora vários marcadores do sangue periférico se encontrem em estudo. Os autores apresentam um caso clínico de uma mulher que sobreviveu a um quadro de embolia de líquido amniótico na sua gravidez prévia, e que teve uma gravidez subsequente sem recorrência do quadro, contribuindo com mais um testemunho clínico do baixo risco na gravidez pós-ELA.

Keywords

amniotic fluid embolism - cardiovascular collapse - intravascular disseminated coagulation - maternal death

Palavras-chave

embolia do líquido amniótico - colapso cardiovascular - coagulação intravascular disseminada - morte materna
 

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