Abstract:
OBJECTIVE:We sought to provide evidence-based guidelines regarding the diagnosis and management of amniotic fluid embolism. STUDY DESIGN:A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through March 2015. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted. Abstracts of research presented at symposia and scientific conferences were not considered adequate for inclusion. Evidence reports and published guidelines were also reviewed, and additional studies were located by reviewing bibliographies of identified articles. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used for defining the strength of recommendations and rating quality of the evidence. Consistent with US Preventive Task Force guidelines, references were evaluated for quality based on the highest level of evidence. RESULTS AND RECOMMENDATIONS:We recommend the following: (1) we recommend consideration of amniotic fluid embolism in the differential diagnosis of sudden cardiorespiratory collapse in the laboring or recently delivered woman (GRADE 1C); (2) we do not recommend the use of any specific diagnostic laboratory test to either confirm or refute the diagnosis of amniotic fluid embolism; at the present time, amniotic fluid embolism remains a clinical diagnosis (GRADE 1C); (3) we recommend the provision of immediate high-quality cardiopulmonary resuscitation with standard basic cardiac life support and advanced cardiac life support protocols in patients who develop cardiac arrest associated with amniotic fluid embolism (GRADE 1C); (4) we recommend that a multidisciplinary team including anesthesia, respiratory therapy, critical care, and maternal-fetal medicine should be involved in the ongoing care of women with AFE (Best Practice); (5) following cardiac arrest with amniotic fluid embolism, we recommend immediate delivery in the presence of a fetus ≥23 weeks of gestation (GRADE 2C); (6) we recommend the provision of adequate oxygenation and ventilation and, when indicated by hemodynamic status, the use of vasopressors and inotropic agents in the initial management of amniotic fluid embolism. Excessive fluid administration should be avoided (GRADE 1C); and (7) because coagulopathy may follow cardiovascular collapse with amniotic fluid embolism, we recommend the early assessment of clotting status and early aggressive management of clinical bleeding with standard massive transfusion protocols (GRADE 1C).
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org.,Pacheco LD,Saade G,Hankins GD,Clark SLdoi
10.1016/j.ajog.2016.03.012subject
Has Abstractpub_date
2016-08-01 00:00:00pages
B16-24issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(16)00474-9journal_volume
215pub_type
杂志文章,实务指引abstract:OBJECTIVE:The purpose of this study was to assess the involvement of rho kinase (ROK) in agonist-dependent contraction of omental, myometrial, and placental arteries of pregnant women at term. STUDY DESIGN:Wire myography was used to assess if contractions of intact or alpha-toxin-permeabilized arteries obtained from w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.076
更新日期:2005-09-01 00:00:00
abstract::A case of nonimmune hydrops fetalis in association with angioosteohypertrophy (Klippel-Trenaunay) syndrome is reported for the first time. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90443-7
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to assess cerclage to prevent recurrent preterm birth in women with short cervix. STUDY DESIGN:Women with prior spontaneous preterm birth less than 34 weeks were screened for short cervix and randomly assigned to cerclage if cervical length was less than 25 mm. RESULTS:Of 1014...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ajog.2009.08.015
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:We sought to determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation and virtual organ computer-aided analysis. STUDY DESIGN:A cross-sectional study was performed in fetuses with umbilical artery pulsatility index...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.11.043
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Planned home births have leveled off in the United States in recent years after a significant rise starting in the mid-2000s. Planned home births in the United States are associated with increased patient-risk profiles. Multiple studies concluded that, compared with hospital births, absolute and relative ris...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.01.045
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the efficacy of 3 previously described ovarian cancer serum biomarkers (apolipoprotein-1 [ApoA-I], prealbumin [TTR], transferrin [TF]) in the detection of endometrioid and papillary serous adenocarcinoma of the endometrium. STUDY DESIGN:ApoA-I, TTR, and TF levels ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.07.049
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate whether a significant association exists between cocaine use, cervical, urine, and/or Group B streptococcus (GBS) infections and preterm birth (PTB) in patients admitted with active preterm labor (PTL). STUDY DESIGN:A retrospective cohort study of PTL patients < 34 weeks (n = 40...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.10.777
更新日期:2008-05-01 00:00:00
abstract::Virilization in pregnancy has been reported with various ovarian neoplasms. Presented is a case of maternal virilization resulting from an unclassified sex-cord stromal neoplasm. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90627-1
更新日期:1985-07-01 00:00:00
abstract::At the Department of Obstetrics and Gynecology of Tohoku University, radical hysterectomy with pelvic lymphadenectomy had been performed on patients with microinvasive carcinoma of the uterine cervix before 1966. Investigation of lymph nodes of 90 patients treated in this manner has shown no lymph node metastasis of t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32996-9
更新日期:1979-11-01 00:00:00
abstract:OBJECTIVE:Our purpose was to measure erythrocyte indexes in fetuses with two grades of Doppler-defined umbilical placental insufficiency. STUDY DESIGN:A prospective study comprising 110 infants categorized into control, moderate, and severe groups by umbilical artery waveform studies was undertaken at the University o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90090-6
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:We sought to determine the fetal injury rate associated with shoulder dystocia and to determine whether there is a higher rate of brachial plexus injury or bone fracture when fetal manipulation techniques are required for delivery. STUDY DESIGN:A retrospective review of 285 cases of shoulder dystocia that oc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70312-6
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:The study was performed to test the knot integrity of parallel and nonidentical sliding knots with the use of monofilament suture. STUDY DESIGN:We investigated the proportion of parallel sliding knots that become untied compared with nonidentical sliding knots in four different monofilament suture configurat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(03)00947-5
更新日期:2004-01-01 00:00:00
abstract::Smoking increases the risk of lung cancer and cardiovascular disease among persons of both sexes. The risk of cardiovascular disease is further increased among users of oral contraceptives who smoke, particularly those who are >/=35 years old or carry the coagulation factor V Leiden mutation. Other important cardiovas...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(99)70695-2
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:Fetal interventions have clearly decreased mortality, but the neurological outcomes of survivors are of critical concern. Here we consolidated available data on long-term neurological outcomes after common fetal interventions to guide counseling, management, and future research. STUDY DESIGN:Published studie...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2014.10.1092
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine conservative conization as treatment for microinvasive carcinoma of the cervix with depth of invasion < 3 mm. STUDY DESIGN:Twelve patients with microinvasive carcinoma of the cervix underwent cervical conization under colposcopic guidance followed by careful observation. RESULTS:T...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70394-6
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:Antiphospholipid antibodies are associated with clinical intrauterine growth restriction. In this study we investigated whether immunoglobulin M monoclonal antibodies against phosphatidylserine or cardiolipin or cross-reactive with both phospholipids would induce intrauterine growth restriction in an experime...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70453-2
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:We sought to determine the proportion of evidence-based (EB), vs non-EB (NEB) iatrogenic late preterm birth, and to compare corresponding rates of neonatal intensive care unit (NICU) admission. STUDY DESIGN:We performed a retrospective cohort study. Cases were categorized as EB or NEB. NICU admission was com...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.08.007
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:We characterized US women's preferred and usual sources of reproductive health care. STUDY DESIGN:Data were drawn from the Women's Health Care Experiences and Preferences Study, an Internet survey of 1078 women aged 18-55 years randomly sampled from a national probability panel. We described and compared wom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.04.025
更新日期:2015-09-01 00:00:00
abstract::Forty-five of 49 patients were aborted successfully with 15(S)-15-Me-PGF2alpha after previous techniques to induce abortion had met with failure in 39. Nine patients had spontaneous premature rupture of membranes without onset of labor. The majority of patients aborted within 7 hours following initiation of this metho...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90465-4
更新日期:1979-01-15 00:00:00
abstract:OBJECTIVE:We examined intraplacental color Doppler flow patterns and spectral Doppler flow velocity waveforms of villous arteries in pregnancies with intrauterine growth retardation. STUDY DESIGN:A total of 192 uncomplicated pregnancies and 29 pregnancies with intrauterine growth retardation between 26 and 41 weeks' g...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90143-0
更新日期:1994-11-01 00:00:00
abstract::The National Institutes of Health funding for reproductive sciences research, specifically in academic departments of obstetrics and gynecology, is disproportionately low. Research is one of the most important pillars in advancing healthcare. Despite US Congress' vision in providing increased funding to the National I...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.03.022
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to quantitatively assess the effects of oxytocin on membrane properties in the pregnant human myometrium. STUDY DESIGN:Specimens were obtained from the lower uterine segment during cesarean section at term. Electrical activity was recorded from individual cells by a conventional microelectrod...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70465-4
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate the hemodynamic effects of oral nifedipine in preeclamptic hypertensive emergencies. STUDY DESIGN:A prospective observational study of the hemodynamic effects of oral nifedipine was conducted with severely preeclamptic patients receiving magnesium sulfate infusion during a hyperte...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70143-6
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate maternal alloimmunization to paternal leukocytes as a treatment for hemolytic disease of the fetus/newborn in a rabbit model. STUDY DESIGN:Twelve does and paired red blood cell-incompatible bucks underwent the experimental protocol. Fetal hematologic parameters that ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.126960
更新日期:2002-10-01 00:00:00
abstract::A severely Rh-isoimmunized pregnancy is described in which an intrauterine transfusion of blood was given by the intravascular route directly into an umbilical vessel. Fetoscopy was not used, and the procedure was performed percutaneously under direct ultrasound visualization. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90613-7
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine cervical cancer screening practices of obstetrician/gynecologists in the US after recent revised guidelines. STUDY DESIGN:Questionnaires were mailed to 355 randomly selected US obstetrician/gynecologists. Questions were structured as clinical vignettes. RESULTS:Que...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.09.026
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:We attempted to determine whether the antiemetic ondansetron would be more effective than promethazine in treating hyperemesis gravidarum. STUDY DESIGN:Patients with hyperemesis gravidarum who required hospital admission were randomized to receive either intravenous ondansetron (n = 15) or intravenous promet...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9378(96)70607-5
更新日期:1996-05-01 00:00:00
abstract::Acute vaginitis is one of the most common diseases seen in the practice of office gynecology. Large survey studies of women with lower genital tract symptoms suggestive of vaginitis have demonstrated the presence of three major etiologic categories in acute vaginitis: (1) nonspecific vaginosis (Gardnerella vaginalis),...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80002-8
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVE:We sought to determine maternal factors that influence success of labor induction and whether the probability of cesarean delivery changed with time during induction. STUDY DESIGN:We performed a retrospective cohort study of 1650 singleton pregnancies induced at a gestation of 37 weeks or longer, with birthw...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.06.072
更新日期:2008-09-01 00:00:00
abstract::Patients who develop polyarteritis nodosa in pregnancy generally have a grim prognosis. A young nulliparous woman developed the disease and attained remission before becoming pregnant. Although she developed a recurrence, both mother and infant did well. It appears that if a patient becomes pregnant while in remission...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(89)80039-0
更新日期:1989-03-01 00:00:00