We present a patient with sudden cardiovascular collapse during cesarean delivery that was attributed to amniotic fluid embolism (AFE). The syndrome of AFE may be initiated by an anaphylactoid response to amniotic fluid in the maternal circulation that triggers the release of pulmonary vasoconstrictors, with transient pulmonary vasospasm, causing hemodynamic collapse and profound left ventricular failure. Milrinone, a pulmonary vasodilator used in the management of emergent right ventricular failure, was administered via a nebulizer in an effort to decrease pulmonary vascular resistance. If used immediately after AFE, inhaled milrinone may mitigate pulmonary vasoconstriction, providing a bridge to extracorporeal membrane oxygenation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1213/XAA.0000000000001342 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hepatic and Pancreatic Cellular Response to Early Life Nutritional Mismatch.
Endocrinology
January 2025
Department of Pediatrics, Divisions of Neonatology & Developmental Biology and Endocrinology, Neonatal Research Center of the UCLA Children's Discovery & Innovation Institute at the David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1752.
To determine the basis for perinatal nutritional mismatch causing metabolic dysfunction associated steatotic liver disease (MASLD) and diabetes mellitus, we examined adult phenotype, hepatic transcriptome, and pancreatic β-islet function. In prenatal caloric restricted rat with intrauterine growth restriction (IUGR) and postnatal exposure to high fat with fructose (HFhf) or high carbohydrate (RC), we investigated male and female IUGR-Hfhf and IUGR-RC, versus HFhf and CON offspring. Males more than females displayed adiposity, glucose intolerance, insulin resistance, hyperlipidemia, hepatomegaly with hepatic steatosis.
View Article and Find Full Text PDFAmniotic fluid stem cell extracellular vesicles as a novel fetal therapy for pulmonary hypoplasia: a review on mechanisms and translational potential.
Stem Cells Transl Med
January 2025
Developmental and Stem Cell Biology Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada M5G 0A4.
Disruption of developmental processes affecting the fetal lung leads to pulmonary hypoplasia. Pulmonary hypoplasia results from several conditions including congenital diaphragmatic hernia (CDH) and oligohydramnios. Both entities have high morbidity and mortality, and no effective therapy that fully restores normal lung development.
View Article and Find Full Text PDFQuantification of maternal and fetal valaciclovir exposure in a pharmacokinetic study of cytomegalovirus-infected pregnant women treated to prevent vertical transmission.
J Antimicrob Chemother
January 2025
URP 7328 Federation for Research into Innovative Explorations and Therapeutics in Utero, University of Paris-Cité, Paris, France.
Background: In cases of maternal primary infection with cytomegalovirus (CMV-MPI) maternal treatment with oral valaciclovir 8 g/day has been shown to reduce the risk of fetal infection. The pharmacological profile of this high dosage during pregnancy is not yet known.
Objectives: To quantify maternal-fetal exposure to valaciclovir 8 g/day in a population pharmacokinetic (popPK) study.
Assessing Second Trimester Ferning in Diagnosing Preterm Prelabor Rupture of Membranes.
Am J Perinatol
January 2025
MFM, Albany Medical Center, Albany, United States.
Preterm prelabor rupture of membranes (PPROM) diagnosis is made through visualization of amniotic fluid (pooling), nitrizine testing, sonographic low amniotic fluid, and microscopic detection of amniotic fluid arborization (ferning). Data exits on the specificity and sensitivity of ferning detection but has not focused on the second trimester. Our objective is to evaluate the presence of ferning in transvaginally collected amniotic fluid in pregnancies with known second trimester PPROM to determine if there is a difference in ferning based on gestational age and sample drying time.
View Article and Find Full Text PDFToo Much of a Good Thing: Updated Current Management and Perinatal Outcomes of Polyhydramnios.
J Med Ultrasound
November 2024
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Amniotic fluid assessment is crucial in prenatal ultrasound to monitor fetal conditions, with polyhydramnios, characterized by excessive amniotic fluid, affecting 1%-2% of pregnancies. Polyhydramnios is linked to complications such as placental abruption, preterm labor, congenital anomalies, and postpartum hemorrhage, emphasizing the need for early detection and management. While idiopathic causes account for 60%-70% of cases, other causes include impaired fetal swallowing and increased urine production due to maternal, fetal, and placental conditions.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!