![]() The initial dosing of the epidural included a 2-ml, 2% lidocaine subarachnoid test dose followed 5 min later by a 5-ml, 2% lidocaine intravenous test dose both test doses were considered negative. ![]() An epidural was requested for labor analgesia and was placed without incident. Her platelet count on admission was 220,000/ml. Her pregnancy was complicated by diet-controlled gestational diabetes and mild preeclampsia. ![]() 3, 4, 8Ī 42-yr-old woman, at 38 weeks gestation of her fourth pregnancy (gravida 4, para 3) and obese (110 kg), experienced spontaneous onset of contractions. These criteria included acute maternal cardiovascular collapse with evidence of respiratory compromise and/or coagulopathy. More recent incidence data results from national registries in the United States and the United Kingdom, which used clinical entry criteria in laboring women or parturients undergoing cesarean section or dilation and evacuation of an intrauterine fetal demise. 6, –, 8First reported by Meyer in 1926, 9and then later identified as a syndrome in 1941 by Steiner and Lushbaugh, 10AFE has historically been a postmortem diagnosis confirmed only at autopsy revealing epithelial squamous cells, lanugo hair, and fat from vernix or infantile mucin in the maternal pulmonary vasculature. Fetal outcome remains poor if AFE occurs before delivery, with a neonatal mortality rate approximately 10%. 3, –, 5This decrease in risk for maternal mortality from AFE may be the result of previous diagnosis and better resuscitative care as well as changes to case inclusion criteria. Early studies revealed mortality rates as high as 61–86%, but more recent estimates suggest a case fatality of 13–26%. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |