Amniotic fluid embolism in an Australian population-based cohort
C L Roberts1, C S Algert, M Knight
1Kolling Institute of Medical Research, University of Sydney, NSW, Australia. clroberts@med.usyd.edu.au
BJOG : an International Journal of Obstetrics and Gynaecology
|December 4, 2010
Summary
Amniotic fluid embolism (AFE) affects 3.3 per 100,000 births, with high maternal and perinatal mortality. Survivors face risks like cerebral infarction, highlighting AFE
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Epidemiology
Background:
- Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric emergency.
- Limited data exists on the true incidence, mortality, and morbidity of AFE in large populations.
Purpose of the Study:
- To determine the incidence, maternal fatality rate, and perinatal mortality rate of amniotic fluid embolism (AFE).
- To identify novel risk factors and assess long-term morbidity in AFE survivors.
Main Methods:
- Utilized linked birth, hospital, and death data for the entire population.
- Identified AFE cases using International Classification of Diseases, 10th Revision (ICD-10) codes with additional criteria.
- Calculated incidence, maternal fatality, and perinatal mortality rates with confidence intervals.
Main Results:
- AFE incidence was 3.3 per 100,000 births.
- Maternal fatality rate was 35%, and perinatal mortality rate was 32%.
- Risk factors included induction with vaginal prostaglandin and manual placenta removal; survivors had increased cerebral infarction risk.
Conclusions:
- AFE has significant maternal and perinatal mortality, despite two-thirds survival.
- Severe morbidity, including cerebral infarction, affects survivors.
- New risk factors identified warrant further investigation.
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