title: Amniotic components in the uterine vasculature and their role in amniotic fluid embolism.
abstract: OBJECTIVE
  To evaluate whether the presence of amniotic components in the maternal uterine vasculature could be a specific pathological indicator for amniotic fluid embolism (AFE).
  
  
  METHODS
  Medical records of patients treated between January 2006 and March 2013 were retrospectively examined to identify patients who underwent post-partum hysterectomy or autopsy due to maternal death. Three subjects with AFE with disseminated intravascular coagulation (DIC)-type post-partum hemorrhage (PPH), and 13 non-AFE subjects were included in analysis. Histochemical staining using hematoxylin-eosin (HE) and alcian blue, and immunohistochemical staining for sialyl-Tn were conducted to detect amniotic components in the maternal uterine vasculature.
  
  
  RESULTS
  Alcian blue was positive for amniotic components in the uterine vasculature of all subjects with AFE and of several subjects without AFE. Similarly, HE and sialyl-Tn were negative in some AFE subjects and positive in some non-AFE subjects.
  
  
  CONCLUSIONS
  The presence of maternal intravascular fetal material is not a specific indicator for AFE with DIC-type PPH. Therefore, the presence of fetal components in the uterine vasculature is unlikely to be a definitive indicator for AFE.
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Nakagami
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kajihara
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kamei
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishihara
authors.affiliation: Department of Pathology, Saitama Medical University, Saitama, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kayano
authors.affiliation: Department of Pathology, Saitama Medical University, Saitama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sasaki
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Itakura
mesh_terms: D000653:Amniotic Fluid / Q000737:chemistry*; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood / Q000737:chemistry; D015415:Biomarkers / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D004619:Embolism, Amniotic Fluid / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D006473:Postpartum Hemorrhage / Q000209:etiology; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014599:Uterus / Q000098:blood supply* / Q000737:chemistry
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D015415:Biomarkers; C055491:sialosyl-Tn antigen
keywords: alcian blue; amniotic fluid embolism; disseminated intravascular coagulation; post-partum hysterectomy