[Intravascular coagulation in amniotic fluid embolism]

Amniotic embolism (AE) was established in 13 (8.13% out of 160 dead pregnant women and parturients. The morphological examination and clinico-anatomical analysis showed that the degree of obstruction of lung microcirculatory bed was of substantial significance for the course of the disease. Intravascular coagulation (IC) was found in 11 (84.6%) of women with AE. Lungs were damaged by microthrombi most frequently and most severely, which was connected with direct contact activation of blood clotting system by the amniotic fluid. Characteristic peculiarities of AE were their jerk-like course with subclinical period of various duration and early secondary activation of the fibrinolytic system. The morphological sign of the latter was the presence of hyaline globules even within the first hour since the clinical onset of AE. IC and the connected with it acute respiratory insufficiency and consumption coagulopathy were the main thanatogenic factors in AE. This imposed dynamic follow-up of coagulation status and fibrinolytic activity combined with timely anticoagulant and antifibrinolytic treatment.