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Squamous cells in the maternal pulmonary circulation.

S L Clark, Z Pavlova, J Greenspoon

American Journal of Obstetrics and Gynecology

|January 1, 1986

Summary

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Squamous cells in maternal pulmonary arteries are not definitive proof of amniotic fluid embolism. Increased cell counts in pregnant women may indicate fetal origin, but other causes of instability should be investigated.

Area of Science:

Obstetrics and Gynecology
Pulmonary Medicine
Pathology

Background:

Squamous cells in maternal pulmonary arteries are traditionally considered pathognomonic for amniotic fluid embolism (AFE).
Pulmonary artery catheterization is used in critically ill pregnant patients for hemodynamic monitoring.

Purpose of the Study:

To investigate the significance of squamous cells detected in the pulmonary arterial circulation of pregnant women.
To determine if squamous cells are reliably indicative of amniotic fluid embolism.

Main Methods:

Pulmonary arterial catheterization was performed on 16 pregnant women for various medical reasons.
Buffy coat fractions from distal lumen aspirates were examined for squamous cells.
Control specimens from 17 nonpregnant patients were analyzed for comparison.

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Main Results:

Squamous cells were identified in all 16 pregnant patients and in the control group.
A significantly higher count of squamous cells was observed in pregnant patients compared to nonpregnant controls.
Differentiation between adult and fetal squamous cells was not possible.

Conclusions:

The presence of squamous cells in the maternal pulmonary arterial circulation is not pathognomonic for amniotic fluid embolism.
The increased cell count in pregnant women suggests a potential fetal origin.
Clinicians should not solely rely on this finding and must consider other causes of hemodynamic instability in critically ill obstetric patients.