Does pitocin increase your risk for amniotic fluid embolism in labor? скачать в хорошем качестве

Does pitocin increase your risk for amniotic fluid embolism in labor?

From UpToDate: -Amniotic fluid embolism (AFE) is a catastrophic condition that typically occurs during labor or within 30 minutes postpartum. -AFE is rare (1 to 12 cases per 100,000 deliveries) and often lethal. -The pathophysiology of AFE is poorly understood but may be due to a vasospastic, inflammatory, and/or immune reaction to the presence of amniotic debris or other antigens in the maternal circulation. No useful identifying risk factors have been described. AFE should be suspected in patients who develop sudden cardiovascular collapse, hypoxemia, and hemorrhage in association with disseminated intravascular coagulopathy (DIC) during labor and delivery in the absence of other explanations. Uncommonly, DIC may be the initial presenting feature or may be absent. -Initial strategies should focus on standard basic and advanced cardiac life support maneuvers to treat shock and cardiopulmonary compromise so that adequate tissue perfusion for both mother and fetus (if not yet delivered) can be ensured. This typically involves manual chest percussions, emergency airway management with supplemental oxygen and intubation, and the establishment of intravenous (IV) access, for fluid resuscitation and arrhythmia management. Vasopressors should be administered to those whose shock is refractory to resuscitative measures. -For patients who present with hemorrhage, immediate and rapid transfusion of blood products is critical. In almost all suspected cases of AFE, activation of a massive transfusion protocol is recommended. -The need for immediate delivery must be determined on a case-by-case basis, but factors that favor urgent cesarean delivery include a nonreassuring fetal heart rate tracing of a fetus at or above the limit of viability and as part of the interventions for maternal resuscitation when the fetus is over 22 to 23 weeks of gestation. #afe #amnioticfluidembolism *********************************** Welcome to my channel and be sure to hit “subscribe”!   I am a double board certified ObGyn and Maternal-Fetal Medicine specialist focusing on the care of people with maternal and/or fetal complications of pregnancy. I discuss hot topics related to fertility, pregnancy and the postpartum period, and do a little myth-busting and fact-checking to keep things real! Not only am I a doc, but I was also a patient who had infertility, a high-risk twin pregnancy and preterm delivery, and NICU stay at age 43 as a first-time mom--so I GET IT! Leave requests for new topics in comments!   *********************************** Follow me on social media and elsewhere! Instagram and Facebook: Babies After 35 TikTok: babies_after_35 Website: BabiesAfter35.com Email: [email protected] *********************************** DISCLAIMER: This channel is provided for educational and informational purposes only and does not constitute providing medical advice. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with their physician or other healthcare provider. Views expressed here do not represent the views of Dr. Clark's employer.