Amniotic fluid embolism-risk factors, maternal and neonatal outcomes.
OBJECTIVE
To investigate demographic characteristics, risk factors, maternal and neonatal outcomes of all cases of amniotic fluid embolism that occurred in New Jersey during 1997-2005.


METHODS
Information was derived from a perinatal linked dataset provided by the MCH-Epidemiology Program in the New Jersey Department of Health. Bivariate analysis for dichotomous variables used the Chi-square test. Stepwise logistic regression models were created to assess the influence of potential risk factors and p value < 0.05 considered statistically significant.


RESULTS
Forty-five cases of amniotic fluid embolism were identified among 1,004,116 deliveries, for a prevalence rate of 1 in 22,313 pregnancies. Statistically, significant association was found with multifetal pregnancy, caesarean section, placenta previa, placental abruption, eclampsia and cervical laceration. The rate of maternal complications such as coagulopathy, seizures, neurological damage, shock and cardiac arrest were significantly greater in the cases as compared with the overall study population. Neonatal morbidity was significant as demonstrated by higher NICU admissions and neonatal intubation rates and lower 5-min Apgar scores.


CONCLUSIONS
Significant correlation was identified between historically reported risk factors and amniotic fluid embolism. The fetal and maternal mortality rates were lower compared with previous studies, attributed both to improvements in perinatal healthcare and reporting of 'milder' cases.
Spiliopoulos
Michail
M
Department of Obstetrics and Gynecology, Temple University Hospital, Philadelphia, PA 19140, USA. spilias112@yahoo.gr
Puri
Isha
I
Jain
Neetu J
NJ
Kruse
Lakota
L
Mastrogiannis
Dimitrios
D
Dandolu
Vani
V
D000293:Adolescent; D000328:Adult; D004619:Embolism, Amniotic Fluid / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology; D008431:Maternal-Fetal Exchange / Q000502:physiology; D008875:Middle Aged; D009017:Morbidity; D009035:Mothers; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult