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Factor VIIa treatment of DIC as a clinical manifestation of amniotic fluid embolism in a patient with fetal demise

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Abstract

Introduction

A pregnant patient, with term intrauterine fetal demise, who developed cardiopulmonary arrest during labor, followed by disseminated intravascular coagulation (DIC) secondary to amniotic fluid embolism (AFE) that was treated with Recombinant Factor VIIa, is presented.

Case report

A 22-year-old Turkish woman was admitted to our antenatal clinic at 39 weeks 6 days of gestation with a complaint of decreased fetal movements for the previous 3 days. Shortly after presentation, she was noted to have circumoral cyanosis with shortness of breath and sudden loss of consciousness. After a 3,220 g macerated male fetus was delivered, persistent bleeding occurred in the mother and was managed with Recombinant Factor VIIa at a dose of 90 mcg/kg. She died 8 days after the admission due to multiple organ failure.

Conclusion

Recombinant Factor VIIa may be a treatment option for hemorrhage in patients with DIC related to AFE.

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References

  1. Clark SL, Hankins GDV, Dudley DA, Didly GA, Porter TF (1995) Amniotic fluid embolism; analysis of the national registry. Am J Obstet Gynecol 172:1158–1169. doi:10.1016/0002-9378(95)91474-9

    Article  PubMed  CAS  Google Scholar 

  2. Morgan M (1979) Amniotic fluid embolism. Anaesthesia 34:20–32. doi:10.1111/j.1365-2044.1979.tb04862.x

    Article  PubMed  CAS  Google Scholar 

  3. Davies S (2001) Amniotic fluid embolus: a review of the literature. Can J Anaesth 48:88–98

    Article  PubMed  CAS  Google Scholar 

  4. Benson M, Lindberg R (1996) Amniotic fluid embolism, anaphylaxis, and tryptase. Am J Obstet Gynecol 175:737. doi:10.1053/ob.1996.v175.a74918

    Article  PubMed  CAS  Google Scholar 

  5. Steiner PE, Lushbaugh CC (1941) Maternal pulmonary embolism by amniotic fluid. JAMA 117:1340–1345

    Google Scholar 

  6. Mason RG (1992) Amniotic fluid embolism. Clin Chest Med 13:657–665

    Google Scholar 

  7. Steiner PE, Lushbaugh CC (1986) Maternal pulmonary embolism by amniotic fluid as a cause of obstetric shock and unexpected deaths in obstetrics. JAMA 255:2187–2203. doi:10.1001/jama.255.16.2187

    Article  PubMed  CAS  Google Scholar 

  8. Ray BK, Vallejo MC, Creinin MD, Shannon KT, Mandel GL, Kaul B, Ramanathan S (2004) Amniotic fluid embolism with second trimester pregnancy termination: a case report. Can J Anaesth 51(2):139–144

    Article  PubMed  Google Scholar 

  9. Courtney LD (1974) Amniotic fluid embolism. Obstet Gynecol Surv 29:169–177. doi:10.1097/00006254-197403000-00001

    Article  PubMed  CAS  Google Scholar 

  10. Mc Doughall RJ, Duke GJ (1995) Amniotic fluid embolism syndrome: case report and review. Anaesth Intensive Care 23:735–740

    Google Scholar 

  11. Clark SL (1990) New concepts of amniotic fluid embolism: a review. Obstet Gynecol Surv 45:360–368. doi:10.1097/00006254-199006000-00003

    Article  PubMed  CAS  Google Scholar 

  12. Marcus BJ, Collins KA, Harley RA (2005) Ancillary studies in amniotic fluid embolism: a case report and review of the literature. Am J Forensic Med Pathol 26:92–95. doi:10.1097/01.paf.0000154255.67466.8e

    Article  PubMed  Google Scholar 

  13. Clark SL, Pavlova Z, Greenspoon J, Horenstein J, Phelan JP (1986) Squamous cells in the maternal pulmonary circulation. Am J Obstet Gynecol 154:104–106

    PubMed  CAS  Google Scholar 

  14. Kobayashi H, Ohi H, Terao T (1993) A simple non invasive, sensitive method for diagnosis of amniotic fluid embolism by monoclonal antibody TKH-2 that recognises NeuAc2-6GallNAc. Am J Obstet Gynecol 168:848–853

    PubMed  CAS  Google Scholar 

  15. Kanayama N, Yamazaki T, Naruse H, Suminoto K, Horiuchi K, Terao T (1992) Determining zinc coproporphyrin in maternal plasma- a new method for diagnosing amniotic fluid embolism. Clin Chem 38:526–529

    PubMed  CAS  Google Scholar 

  16. Lawson HW, Atrash HK, Franks AL (1990) Fatal pulmonary embolism during legal induced abortion in the United States from 1972 to 1985. Am J Obstet Gynecol 162:986–990

    PubMed  CAS  Google Scholar 

  17. Lim Y, Loo CC, Chia V, Fun W (2004) Recombinant Factor VIIa after amniotic fluid embolism and disseminated intravascular coagulopathy. Int J Gynaecol Obstet 87(2):178–179. doi:10.1016/j.ijgo.2004.08.007

    Article  PubMed  CAS  Google Scholar 

  18. Segal S, Shemesh I, Blumental R, Yoffe B, Laufer N, Mankuta D, Mazor M, Zohar S, Schiff E, Martinovitz U (2004) The use of Recombinant Factor VIIa in a severe postpartum hemorrhage. Acta Obstet Gynecol Scand 83:771–772. doi:10.1111/j.0001-6349.2004.00501.x

    Article  PubMed  Google Scholar 

  19. Boehlen F, Morales MA, Fontana P, Ricou B, Irion O, Moerloose P (2004) Prolonged treatment of massive postpartum hemorrhage with recombinant factor VIIa: case report and review of the literature. BJOG 111:284–287. doi:10.1111/j.1471-0528.2004.00058.x

    Article  PubMed  Google Scholar 

  20. Mato J (2008) Suspected amniotic fluid embolism following amniotomy: a case report. AANA J 76(1):53–59

    PubMed  Google Scholar 

  21. Stroup J, Haraway D, Beal JM (2006) Aprotinin in the management of coagulopathy associated with amniotic fluid embolus. Pharmacotherapy 26(5):689–693

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of High Risk Pregnancies, Zekai Tahir Burak Women’s Health and Education Hospital, Ankara, Turkey

    Inci Kahyaoglu & Leyla Mollamahmutoglu

  2. Obstetrics and Gynecology, Golbasi Hasvak State Hospital, Ankara, Turkey

    Serkan Kahyaoglu

Authors
  1. Inci Kahyaoglu
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  2. Serkan Kahyaoglu
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  3. Leyla Mollamahmutoglu
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Correspondence to Serkan Kahyaoglu.

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Kahyaoglu, I., Kahyaoglu, S. & Mollamahmutoglu, L. Factor VIIa treatment of DIC as a clinical manifestation of amniotic fluid embolism in a patient with fetal demise. Arch Gynecol Obstet 280, 127–129 (2009). https://doi.org/10.1007/s00404-008-0857-3

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  • DOI: https://doi.org/10.1007/s00404-008-0857-3

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