Amniotic fluid embolism-risk factors, maternal and neonatal outcomes

Michail Spiliopoulos, Isha Puri, Neetu J. Jain, Lakota Kruse, Dimitrios Mastrogiannis, Vani Dandolu

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objective. To investigate demographic characteristics, risk factors, maternal and neonatal outcomes of all cases of amniotic fluid embolism that occurred in New Jersey during 19972005. Methods. Information was derived from a perinatal linked dataset provided by the MCH-Epidemiology Program in the New Jersey Department of Health. Bivariate analysis for dichotomous variables used the Chi-square test. Stepwise logistic regression models were created to assess the influence of potential risk factors and p value < 0.05 considered statistically significant. Results. Forty-five cases of amniotic fluid embolism were identified among 1,004,116 deliveries, for a prevalence rate of 1 in 22,313 pregnancies. Statistically, significant association was found with multifetal pregnancy, caesarean section, placenta previa, placental abruption, eclampsia and cervical laceration. The rate of maternal complications such as coagulopathy, seizures, neurological damage, shock and cardiac arrest were significantly greater in the cases as compared with the overall study population. Neonatal morbidity was significant as demonstrated by higher NICU admissions and neonatal intubation rates and lower 5-min Apgar scores. Conclusions. Significant correlation was identified between historically reported risk factors and amniotic fluid embolism. The fetal and maternal mortality rates were lower compared with previous studies, attributed both to improvements in perinatal healthcare and reporting of 'milder' cases.

Original languageEnglish (US)
Pages (from-to)439-444
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume22
Issue number5
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Amniotic fluid embolism
  • Cardiogenic shock
  • Disseminated intravascular coagulation
  • Hypoxic encephalopathy
  • Pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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