Embolia de líquido amniótico: Reporte de cuatro casos en el Hospital Universitario La Paz en Madrid, Espa?a, y revisión de la literatura

摘要

Introduction: Amniotic fluid embolism (AFE) is an infrequent condition considered unpredictable and unpreventable, and it is associated with high maternal morbidity and mortality. Early diagnosis is critical in order to improve prognosis. The objective of this case report is to review the diagnosis, treatment and main discussion points found in the literature regarding this disease condition. Material and methods: We report 4 cases of AFE presenting over a period of 10 years to the Hospital Universitario La Paz, in Madrid, Spain, a high complexity center of the national health system. One of the cases is reported in detail because it is the most representative of the disease presentation in terms of the clinical characteristics and the time sequence of symptom onset. A search was conducted in English and Spanish in Medline via Pub Med for the last 10 years, using the terms amniotic fluid embolism, cardiac arrest, disseminated intravascular coagulation, neonatal mortality. The search included case series, cohort studies, cases and controls, and review articles. Results: Of a total of 150 titles found, 26 were included: 10 case series, 5 cohort studies and 11 reviews. The diagnosis is based on clinical criteria and early treatment is focused on cardiorespiratory and hemodynamic support. Conclusion: Adequate knowledge of AFE is required in order to suspect the diagnosis and guide therapeutic management in these patients as adequately and promptly as possible.