title: Amniotic fluid embolism.
abstract: Amniotic fluid embolism (AFE) is an unpredictable and as-of-yet unpreventable complication of maternity. With its low incidence it is unlikely that any given practitioner will be confronted with a case of AFE. However, this rare occurrence carries a high probability of serious sequelae including cardiac arrest, ARDS, coagulopathy with massive hemorrhage, encephalopathy, seizures, and both maternal and infant mortality. In this review the current state of medical knowledge about AFE is outlined including its incidence, risk factors, diagnosis, pathophysiology, and clinical manifestations. Special attention is paid to the modern aggressive supportive care that resulted in an overall reduction in the still alarmingly high mortality rate of this devastating entity. The key factors for successful management and resolution of this disease process continue to be sharp vigilance, a high level of clinical suspicion, and rapid all-out resuscitative efforts on the part of all clinicians involved in the medical care of the parturient.
authors.affiliation: Department of Anesthesiology, Division of Trauma, Critical Care and Burn, The Ohio State University College of Medicine, Columbus, USA ; Department of Anesthesiology, Srinagarind Hospital, Faculty of Medicine at the Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Cattleya
authors.initials: C
authors.lastname: Thongrong
authors.forename: Pornthep
authors.initials: P
authors.lastname: Kasemsiri
authors.forename: James P
authors.initials: JP
authors.lastname: Hofmann
authors.forename: Sergio D
authors.initials: SD
authors.lastname: Bergese
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Papadimos
authors.forename: Vicente H
authors.initials: VH
authors.lastname: Gracias
authors.forename: Michael D
authors.initials: MD
authors.lastname: Adolph
authors.forename: Stanislaw P A
authors.initials: SP
authors.lastname: Stawicki
keywords: Amniotic fluid embolism; diagnosis; focused summary; management