Referral of Pregnant Women with Amniotic Fluid Embolism: A Retrospective, Descriptive Study

Abstract

Background: Amniotic fluid embolism (AFE) is an urgent, catastrophic obstetric complication, but not all medical settings are equipped to manage AFE. The purpose of this study is to summarize the experience of referral of women with AFE in order to save the lives of women and improve the prognosis. Methods: We retrospectively collected the demographic characteristics, delivery process, symptoms and test indicators at the onset of AFE, as well as the treatment status and outcomes after referral of women with AFE who were treated at our hospital from January 2015 to November 2022. We descriptively summarized and analyzed these data. Results: A total of 13 women with AFE transferred to our hospital were included in the study. After referral, 3 women (23.08%) eventually died. One of the deceased women presented with hypothermia (34.5 °C) at the time of referral, and all 3 fatalities had lactic acidosis (pH <7.35 and lactic acid ≥5 mmol/L) and hypofibrinogenemia (<2 g/L). All 13 women were in shock after referral to our hospital and 92.31% (12/13) of the women were diagnosed with multiple organ dysfunction (MODS) when they were discharged. The markers of heart failure were abnormally elevated in the 3 deceased women. Conclusions: Referral should be considered as soon as possible in women with lactic acidosis, hypofibrinogenemia, and hypothermia with AFE.

Keywords

• amniotic fluid embolism
• pregnancy
• referral
• retrospective study