title: Fatal amniotic fluid embolism with typical pathohistological, histochemical and clinical features.
abstract: Despite the decrease in maternal mortality rate, amniotic fluid embolism (AFE) is still one of the most feared complications of pregnancy due to the high rate of mortality in Japan. The authors present a fatal case of a healthy 39-year-old woman who died during delivery after a normal 40-week second pregnancy. Shortly after the arrival at hospital, an abrupt drop of foetal heart rate was observed, followed by deterioration of consciousness and cardiac arrest of the patient. Prompt cardiopulmonary resuscitation (CPR) was performed but the patient died about an hour and a half after her arrival at hospital. Forensic autopsy confirmed the pathohistological diagnosis of amniotic fluid embolism supported by histochemical analysis results and excluded other possible causes of death. This paper stresses the fundamental importance of autopsy in an unexpected maternal death in conjunction with the significance of data accumulation on maternal death.
authors.affiliation: Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, 4-21-18 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan. hikiji@kyudai.jp
authors.forename: Wakako
authors.initials: W
authors.lastname: Hikiji
authors.forename: Naoaki
authors.initials: N
authors.lastname: Tamura
authors.forename: Akio
authors.initials: A
authors.lastname: Shigeta
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kanayama
authors.forename: Tatsushige
authors.initials: T
authors.lastname: Fukunaga
mesh_terms: D000328:Adult; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis; D003306:Coproporphyrins / Q000032:analysis; D004619:Embolism, Amniotic Fluid / Q000473:pathology*; D005260:Female; D049429:Forensic Pathology; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008168:Lung / Q000737:chemistry* / Q000473:pathology*; D008470:Meconium; D011247:Pregnancy; D011654:Pulmonary Edema / Q000473:pathology; D013194:Staining and Labeling
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D003306:Coproporphyrins; C055491:sialosyl-Tn antigen; C031467:coproporphyrin I