Abstract
Amniotic fluid embolism (AFE) is a rare cause of unexpected late maternal gestational death. The forensic post-mortem diagnosis is rendered upon the histological recognition of fetal “foreign” material inside maternal lung vasculature. The authors propose a double immunohistochemical (anti-CD31 plus anti-cytokeratin AE1/AE3) stain in order to assess accurate amniotic fluid pulmonary embolic burden in a highly reproducible fashion based on the fact that such technique allows to detect an impressive amount of scales within lung vasculature, thereby offering further evidence that pulmonary embolic obstructive microangiopathy, rather than anaphylactoid reaction, is major determinant in AFE-related death.
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References
Clark SL (2014) Amniotic fluid embolism. Obstet Gynecol 123:337–348
Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M (2016) Incidence, risk factors, management and outcomes of amniotic-fluid embolism: a population-based cohort and nested case-control study. BJOG 123:100–109
Fong A, Chau CT, Pan D, Ogunyemi DA (2015) Amniotic fluid embolism: antepartum, intrapartum and demographic factors. J Matern Fetal Neonatal Med 28:793–798
Tamura N, Farhana M, Oda T, Itoh H, Kanayama N (2017) Amniotic fluid embolism: pathophysiology from the perspective of pathology. J Obstet Gynaecol Res 43:627–632
Sinicina I, Pankratz H, Bise K, Matevossian E (2010) Forensic aspects of post-mortem histological detection of amniotic fluid embolism. Int J Legal Med 124:55–62
Attwood HD (1956) Fatal pulmonary embolism by amniotic fluid. J Clin Pathol 9(1):38–46
Chen X, Cho D-B, Yang P-C (2010) Double staining immunohistochemistry. N Am J Med Sci 2(5):241–245
Lee W, Ginsburg KA, Cotton DB, Kaufman RH (1986) Squamous and trophoblastic cells in the maternal pulmonary circulation identified by invasive hemodynamic monitoring during the peripartum period. Am J Obstet Gynecol 155:999–1001
Turillazzi E, Neri M, Bello S, Riezzo I, Fineschi V (2014) Amniotic fluid embolism: moving diagnosis through the time. From the mechanical pulmonary vascular occlusion until an immuno-inflammatory pathogenesis? Curr Pharm Biotechnol 14:1179–1118
Ferrara G, Bradamante M, Broglia I, Petrillo G, Stefanato CM (2020) Melanocytic and pseudomelanocytic nests coexist in interface dermatitis from head-neck sun-exposed skin: a report of three cases, J Cutan Pathol 2020 Feb 28. Online ahead of print
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Tombolini, A., Broglia, I. & Ferrara, G. Technical note: double immunohistochemical stain (anti-CD31 and anti-cytokeratins) as a tool for a confident forensic post-mortem diagnosis of amniotic fluid embolism. Int J Legal Med 135, 355–357 (2021). https://doi.org/10.1007/s00414-020-02331-y
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DOI: https://doi.org/10.1007/s00414-020-02331-y