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Summary of clinically diagnosed amniotic fluid embolism cases in Korea and disagreement with 4 criteria proposed for research purpose

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Author(s)
Jin-ha KimHyun-Joo SeolWon Joon SeongHyun-Mee RyuJin-Gon BaeJoon Seok HongJeong YangJi-Hee SungSuk-Joo ChoiSoo-young OhCheong-Rae Roh
Keimyung Author(s)
Bae, Jin Gon
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Journal Title
Obstetrics & Gynecology Science
Issued Date
2021
Volume
64
Issue
2
Keyword
Amniotic fluid embolismCriteriaDiagnosisKorea
Abstract
Objective:
This study aimed 1) to investigate the clinical characteristics of amniotic fluid embolism (AFE) cases clinically diagnosed by maternal fetal medicine (MFM) specialists in Korea, 2) to check the disagreement with 4 recently proposed criteria by the Society for Maternal-Fetal Medicine (SMFM) for research purpose, and 3) to compare maternal outcomes between cases satisfying all 4 criteria and cases with at least 1 missing criterion.

Methods:
This study included 12 patients clinically diagnosed with AFE from 7 referral hospitals in Korea. We collected information, including maternal age, symptoms of AFE, the amount of transfusion, and maternal mortality.

Results:
The median maternal age was 33 years (range, 28-40 years). Regarding symptoms, cardiovascular arrest, hypotension, respiratory compromise, clinical coagulopathy, and neurologic signs were observed in 41.7%, 83.3%, 83.3%, 100%, and 66.7% of the cases, respectively. Among the 12 cases, 5 women died and 2 suffered severe neurologic disability, showing an intact survival rate of 41.7%. Disagreement with all 4 criteria proposed by the SMFM was found in 66.7% of the cases, due to the lack of criteria for disseminated intravascular coagulation or strict onset time (<30 minutes after delivery). There was no difference in maternal mortality and the amount of transfusion between cases satisfying all 4 criteria and cases with at least 1 missing criterion.

Conclusion:
Two-thirds of clinically confirmed AFE cases did not satisfy all 4 criteria proposed by the SMFM, despite similar rates of maternal mortality with cases satisfying all 4 criteria. Our study suggests that there may be some discrepancy between the clinical diagnosis of AFE and the recent diagnostic criteria proposed by the SMFM for research purpose.
Keimyung Author(s)(Kor)
배진곤
Publisher
School of Medicine (의과대학)
Citation
Jin-ha Kim et al. (2021). Summary of clinically diagnosed amniotic fluid embolism cases in Korea and disagreement with 4 criteria proposed for research purpose. Obstetrics & Gynecology Science, 64(2), 190–200. doi: 10.5468/ogs.20195
Type
Article
ISSN
2287-8580
Source
https://ogscience.org/journal/view.php?number=8610
DOI
10.5468/ogs.20195
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43361
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Obstetrics & Gynecology (산부인과학)
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