Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism
Amniotic fluid embolism (AFE) is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylax...
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Wiley
2012-01-01
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| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2012/946576 |
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| author | Michael D. Benson |
| author_facet | Michael D. Benson |
| author_sort | Michael D. Benson |
| collection | DOAJ |
| description | Amniotic fluid embolism (AFE) is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylaxis appears to be doubtful while the available evidence supports a role for complement activation. With the mechanism remaining to be elucidated, AFE remains a clinical diagnosis. It is diagnosed based on one or more of four key signs/symptoms: cardiovascular collapse, respiratory distress, coagulopathy, and/or coma/seizures. The only laboratory test that reliably supports the diagnosis is the finding of fetal material in the maternal pulmonary circulation at autopsy. Perhaps the most compelling mystery surrounding AFE is not why one in 20,000 parturients are afflicted, but rather how the vast majority of women can tolerate the foreign antigenic presence of their fetus both within their uterus and circulation? |
| format | Article |
| id | doaj-art-3f4db2890d154bfe998e66272b070fc7 |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Developmental Immunology |
| spelling | doaj-art-3f4db2890d154bfe998e66272b070fc72025-02-03T06:04:58ZengWileyClinical and Developmental Immunology1740-25221740-25302012-01-01201210.1155/2012/946576946576Current Concepts of Immunology and Diagnosis in Amniotic Fluid EmbolismMichael D. Benson0Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USAAmniotic fluid embolism (AFE) is one of the leading causes of maternal mortality and morbidity in developed countries. Current thinking about pathophysiology has shifted away from embolism toward a maternal immune response to the fetus. Two immunologic mechanisms have been studied to date. Anaphylaxis appears to be doubtful while the available evidence supports a role for complement activation. With the mechanism remaining to be elucidated, AFE remains a clinical diagnosis. It is diagnosed based on one or more of four key signs/symptoms: cardiovascular collapse, respiratory distress, coagulopathy, and/or coma/seizures. The only laboratory test that reliably supports the diagnosis is the finding of fetal material in the maternal pulmonary circulation at autopsy. Perhaps the most compelling mystery surrounding AFE is not why one in 20,000 parturients are afflicted, but rather how the vast majority of women can tolerate the foreign antigenic presence of their fetus both within their uterus and circulation?http://dx.doi.org/10.1155/2012/946576 |
| spellingShingle | Michael D. Benson Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism Clinical and Developmental Immunology |
| title | Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism |
| title_full | Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism |
| title_fullStr | Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism |
| title_full_unstemmed | Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism |
| title_short | Current Concepts of Immunology and Diagnosis in Amniotic Fluid Embolism |
| title_sort | current concepts of immunology and diagnosis in amniotic fluid embolism |
| url | http://dx.doi.org/10.1155/2012/946576 |
| work_keys_str_mv | AT michaeldbenson currentconceptsofimmunologyanddiagnosisinamnioticfluidembolism |