• Acta Obstet Gynecol Scand · Aug 2012

    Severe maternal morbidity and mortality from amniotic fluid embolism in the Netherlands.

    • Koen H Stolk, Joost J Zwart, Joke Schutte, and Jos VAN Roosmalen.
    • Leiden University Medical Centre, Department of Obstetrics, Leiden, the Netherlands. K.H.Stolk@umail.leidenuniv.nl
    • Acta Obstet Gynecol Scand. 2012 Aug 1; 91 (8): 991-5.

    AbstractWe have assessed the incidence, symptoms and risk factors of amniotic fluid embolism in the Netherlands. Data were retrieved from two nationwide registration systems. From 1983 to 2005 the maternal mortality ratio of amniotic fluid embolism increased from 0.11 to 0.63 (odds ratio (OR) 5.8, 95% confidence interval (CI) 1.3-25.3). The most common signs and symptoms of amniotic fluid embolism were dyspnea and massive obstetric hemorrhage. In the majority of women, onset of symptoms was intrapartum or immediately postpartum. Potential risk factors of developing amniotic fluid embolism were maternal age >30, multiparity (OR 3.3, 95% CI 1.02-10.5), cesarean section (OR 1.3, 95% CI 0.3-5.2) and induction of labor (OR 2.1, 95% CI 2.1-6.1). Perinatal mortality was increased to 38.1% compared with 0.98% in the general pregnant population (p < 0.001) High maternal age and multiparity are the most important risk factors for developing amniotic fluid embolism.© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

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