Report of 3 cases of delayed amniotic fluid embolism.doc

 PAGE \* MERGEFORMAT 9 Report of 3 cases of delayed amniotic fluid embolism Author: Huang Deyu, HUANG Cui-ping, Zhou Shu-wen, Huang Yong Dai [Keywords:] Embolism, amniotic fluid; case report; pathology, clinical Amniotic fluid embolism (AFE) is an extremely serious birth complications, is also one of the important reasons of maternal mortality. Delayed amniotic fluid embolism amniotic fluid embolism due to lack of typical clinical manifestations of acute easily misdiagnosed as uterine atony bleeding delayed treatment. To enhance the understanding of delayed amniotic fluid embolism, the 2007 -2008 year occurred in 3 cases of amniotic fluid embolism deaths due to delayed reporting the following to attract clinician attention. A clinical data 1.1 Case 1 28 years old, pregnant 2 production 1, 40 weeks pregnant, suffered from intermittent abdominal pain under the hospital emergency room. Check the cervix has been opened the whole, fetal heart sound 110 times / min, law Qi, amniotic fluid Ⅱ degree, given the ‘fetal distress’, give oxygen and other first-aid treatment to ROA development of self-produced a normal Apgar score 0 points , weight 3 750 g dead baby boy. Placenta, fetal membranes parturition of integrity, Ⅰ degree perineal laceration, intrapartum hemorrhage 400 ml, post-partum intramuscular injection of oxytocin 20 U, contractions well, leaving the delivery room observations. 2 h after the emergence of maternal shortness of breath, chest pain, vaginal bleeding 1 000 ml, uterine contraction difference immediately for emergency treatment, 3 h after death due to rescue measures proved ineffectual. Autopsy found the body pale skin and mucous membranes, nail cyanosis, left back, right foot back all see eye of a needle injection, and squeeze out a little blood coagulation overflow, perineum at the 9 o’clock position, see a 2.5 cm long wound. The great vessels and the atrio-ventricular cavity were empty, most of the lighter color organs, showing anemia st