title: Risk factors for fatality in amniotic fluid embolism: a systematic review and analysis of a data pool.
abstract: OBJECTIVE
  Investigating risk factors for amniotic fluid embolism (AFE)-induced fatality.
  
  
  METHODS
  A systematic review of cases of AFE available on PubMed, Scielo, Scopus and AJOL databases that occurred from 1990 to 2015 was carried out. After careful reading of titles, abstracts and full texts, case reports of AFE were reviewed. Risk factors for AFE were considered as independent variables in logistic regression models. The first model was built on the whole data pool. The second model was built on typical cases of AFE, according to the classical triad of symptoms (heart, lungs, coagulopathy). The dependent variable was fatality in both models.
  
  
  RESULTS
  177 cases of AFE were assessed in the first model, while 121 typical cases of AFE were assessed in the second model. Among typical cases of AFE, only oxytocin infusion during labour increases the likelihood of death (odds ratio 2.890, 95% confidence interval 1.166-7.164, p = 0.022). No risk factors for fatality were found in the whole data pool.
  
  
  CONCLUSIONS
  Further research on national registries should focus on the behaviour of oxytocin infusion during labour in AFE cases.
authors.affiliation: a Complex Operative Unit of Obstetrics and Gynecology , "Alto Tevere" Hospital of Città di Castello, ASL 1 Umbria , Città di Castello , Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Indraccolo
authors.affiliation: b Department of Gynecological, Obstetrical, and Urological Sciences , "Sapienza" University of Rome , Rome , Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Battistoni
authors.affiliation: b Department of Gynecological, Obstetrical, and Urological Sciences , "Sapienza" University of Rome , Rome , Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Mastrantonio
authors.affiliation: c Department of Surgical and Clinical Sciences and Translational Medicine , "Sapienza" University of Rome , Rome , Italy.
authors.forename: Romolo
authors.initials: R
authors.lastname: Di Iorio
authors.affiliation: d Department of Morphology, Surgery and Experimental Medicine , University of Ferrara , Ferrara , Italy.
authors.forename: Pantaleo
authors.initials: P
authors.lastname: Greco
authors.affiliation: b Department of Gynecological, Obstetrical, and Urological Sciences , "Sapienza" University of Rome , Rome , Italy.
authors.forename: Salvatore Renato
authors.initials: SR
authors.lastname: Indraccolo
mesh_terms: D004619:Embolism, Amniotic Fluid / Q000401:mortality*; D005260:Female; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D012307:Risk Factors
keywords: Amniotic fluid embolism; delivery; labour induction; outcome; oxytocin infusion; pregnancy complications