title: Reproductive decisions after the diagnosis of amniotic fluid embolism.
abstract: OBJECTIVE
  This study aims to describe the subsequent reproductive outcomes in women who either correctly or incorrectly were diagnosed with amniotic fluid embolism (AFE).
  
  
  METHODS
  Medical records were obtained, abstracted and reviewed by authors with extensive experience in critical care obstetrics. Telephone interviews of all survivors were conducted to determine obstetrical and contraceptive history. A subgroup underwent further telephone interview to address subsequent reproductive decisions.
  
  
  RESULTS
  By November 2015, 116 medical records of patients diagnosed with AFE were reviewed. Patients who had undergone hysterectomy (n=26), died (n=9), or developed Sheehan's syndrome (n=1) at the time of the original event were excluded from the present analysis. Of the remaining 80 women, 30% (24/80) had subsequently conceived and 32.5% (26/80) patients or their partners had undergone permanent sterilization. At the time of this report, 66% (21/32) of registry participants were categorized to have had AFE and 34% (11/32) as not likely AFE or indeterminate.
  
  
  CONCLUSIONS
  The syndrome of AFE is over-diagnosed. Women diagnosed with AFE who survive conceive another pregnancy less frequently than US women over similar time intervals and often choose a permanent sterilization method, whether or not they actually had AFE, largely out of fear of AFE recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Moaddab
authors.affiliation: Amniotic Fluid Embolism Foundation, Vista, CA, United States.
authors.forename: Miranda
authors.initials: M
authors.lastname: Klassen
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Priester
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Elvira H
authors.initials: EH
authors.lastname: Munoz
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Belfort
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Clark
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States. Electronic address: gadildy@bcm.edu.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Dildy
mesh_terms: D000328:Adult; D003657:Decision Making; D004619:Embolism, Amniotic Fluid / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D012042:Registries; D012098:Reproduction; D012307:Risk Factors; D055815:Young Adult
keywords: Amniotic fluid embolism; Contraception; Diagnosis; Maternal mortality; Sterilization