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Proposed diagnostic criteria for the case definition of amniotic fluid embolism in research studies.

Abstract：

:Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic fluid embolism is often overdiagnosed in critically ill peripartum women, particularly when an element of coagulopathy is involved. Previously proposed case definitions for amniotic fluid embolism are nonspecific, and when viewed through the eyes of individuals with experience in critical care obstetrics, would include women with a number of medical conditions much more common than amniotic fluid embolism. We convened a working group under the auspices of a committee of the Society for Maternal-Fetal Medicine and the Amniotic Fluid Embolism Foundation whose task was to develop uniform diagnostic criteria for the research reporting of amniotic fluid embolism. These criteria rely on the presence of the classic triad of hemodynamic and respiratory compromise accompanied by strictly defined disseminated intravascular coagulopathy. It is anticipated that limiting research reports involving amniotic fluid embolism to women who meet these criteria will enhance the validity of published data and assist in the identification of risk factors, effective treatments, and possibly useful biomarkers for this condition. A registry has been established in conjunction with the Perinatal Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development to collect both clinical information and laboratory specimens of women with suspected amniotic fluid embolism in the hopes of identifying unique biomarkers of this condition.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Clark SL,Romero R,Dildy GA,Callaghan WM,Smiley RM,Bracey AW,Hankins GD,D'Alton ME,Foley M,Pacheco LD,Vadhera RB,Herlihy JP,Berkowitz RL,Belfort MA

doi

10.1016/j.ajog.2016.06.037

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

408-12

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(16)30382-9

journal_volume

215

pub_type

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Proposed diagnostic criteria for the case definition of amniotic fluid embolism in research studies.