Nonfatal amniotic fluid embolism. Three possible cases and a new clinical definition
M. D. Benson
Highland Park Hospital, IL.
Three obstetrical patients who experienced cardiovascular collapse followed
by disseminated intravascular coagulation were cared for by the author
during residency training and 5 years of private practice. All patients
survived. Their clinical courses were strongly reminiscent of those of
patients described in the medical literature who ultimately died with the
diagnosis of "amniotic fluid embolism." Paradoxically, the mere fact of
survival is generally regarded as proof that a given individual did not
have an amniotic fluid embolism. Proposed herein is a new clinical
definition of amniotic fluid embolism syndrome that could apply to patients
who survive as well as to those who die. With this definition in mind, the
prevalence and prognosis of amniotic fluid embolism syndrome is reexamined.
Finally, the traditional assumption that this syndrome is a result of
amniotic fluid leakage into the maternal circulation is challenged. A new
source is suggested and some new thoughts regarding treatment are provided.
