Management of Postpartum Collapse - AMNIOTIC FLUID EMBOLISM



Presentation

• Extremely sudden severe shock with severe dyspnoea, cyanosis Pulmonary oedema
• Blood stained frothy sputum
• Convulsions may occur  

Onset

• Usually immediately after membranes rupture however it can occur even with intact membranes occurs during strong uterine contractions
• Usually fatal 

Treatment

• Hydrocortisone 1 g I.V. stat
• I.V.  Hartmann 's or N. saline - fast frusemide"80 mg I.V. stat
• Aminophylline 500 mg in 50 cc 50% dextrose over 20 minutes Oxygen inhalation, if available
• 8.4% sodium bicarbonate 100-200 cc I.V.

Transfer to specialist unit if your resuscitation was successful because almost invariably P.P.H. follows due to D.I.C. (disseminated intravascular coagulation)