Document Detail


Current concepts of immunology and diagnosis in amniotic fluid embolism.
MedLine Citation:
PMID:  21969840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Amniotic fluid embolism (AFE) is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylaxis appears to be doubtful while the available evidence supports a role for complement activation. With the mechanism remaining to be elucidated, AFE remains a clinical diagnosis. It is diagnosed based on one or more of four key signs/symptoms: cardiovascular collapse, respiratory distress, coagulopathy, and/or coma/seizures. The only laboratory test that reliably supports the diagnosis is the finding of fetal material in the maternal pulmonary circulation at autopsy. Perhaps the most compelling mystery surrounding AFE is not why one in 20,000 parturients are afflicted, but rather how the vast majority of women can tolerate the foreign antigenic presence of their fetus both within their uterus and circulation?
Authors:
Michael D Benson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2011-09-29
Journal Detail:
Title:  Clinical & developmental immunology     Volume:  2012     ISSN:  1740-2530     ISO Abbreviation:  Clin. Dev. Immunol.     Publication Date:  2012  
Date Detail:
Created Date:  2011-10-04     Completed Date:  2012-01-18     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  101183692     Medline TA:  Clin Dev Immunol     Country:  Egypt    
Other Details:
Languages:  eng     Pagination:  946576     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. m-benson@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Embolism, Amniotic Fluid / diagnosis*,  etiology,  immunology*,  mortality
Female
Humans
Maternal Mortality
Pregnancy
Pregnancy Complications, Cardiovascular / diagnosis
Comments/Corrections

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