Algorithm-based coagulation management of catastrophic amniotic fluid embolism.

Abstract

Amniotic fluid embolism (AFE) is a rare, but often catastrophic, complication of pregnancy and associated with severe coagulopathy. We present an algorithm-based approach in managing coagulopathy and hemorrhage in a fatal case of histopathologically proven AFE. Thrombelastometry was used for rapid evaluation of the coagulation status. Stop of extensive hyperfibrinolysis with tranexamic acid, stabilization of initial clot formation with high-dose fibrinogen and platelet transfusions, and use of prothrombin complex concentrate together with a 1: 1 transfusion regimen of red packed cells and fresh frozen plasma was successful to control diffuse bleeding and restore clot firmness after hysterectomy. Stable clotting situation was maintained despite further clinical deterioration and development of multiple organ failure in this patient.

DOI: 10.1097/MBC.0b013e328332cfe2
020402011201220132014201520162017
Citations per Year

54 Citations

Semantic Scholar estimates that this publication has 54 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Annecke2010AlgorithmbasedCM, title={Algorithm-based coagulation management of catastrophic amniotic fluid embolism.}, author={Thorsten Annecke and Thomas Geisenberger and Rainer K{\"{u}rzl and Randolph Penning and Bernhard Heindl}, journal={Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis}, year={2010}, volume={21 1}, pages={95-100} }