Amniotic fluid embolism incidence, risk factors and outcomes: a review and recommendations

Details

• Alternative Title:
  BMC Pregnancy Childbirth
• Personal Author:
  Knight, Marian ; Berg, Cynthia J. ; Brocklehurst, Peter ; Kramer, Michael ; Lewis, Gwyneth ; Oats, Jeremy ; Roberts, Christine L ; Spong, Catherine ; Sullivan, Elizabeth ; van Roosmalen, Jos ; Zwart, Joost
• Description:
  Background
  
  Amniotic fluid embolism (AFE) is a rare but severe complication of pregnancy. A recent systematic review highlighted apparent differences in the incidence, with studies estimating the incidence of AFE to be more than three times higher in North America than Europe. The aim of this study was to examine population-based regional or national data from five high-resource countries in order to investigate incidence, risk factors and outcomes of AFE and to investigate whether any variation identified could be ascribed to methodological differences between the studies.
  
  Methods
  
  We reviewed available data sources on the incidence of AFE in Australia, Canada, the Netherlands, the United Kingdom and the USA. Where information was available, the risk factors and outcomes of AFE were examined.
  
  Results
  
  The reported incidence of AFE ranged from 1.9 cases per 100 000 maternities (UK) to 6.1 per 100 000 maternities (Australia). There was a clear distinction between rates estimated using different methodologies. The lowest estimated incidence rates were obtained through validated case identification (range 1.9-2.5 cases per 100 000 maternities); rates obtained from retrospective analysis of population discharge databases were significantly higher (range 5.5-6.1 per 100 000 admissions with delivery diagnosis). Older maternal age and induction of labour were consistently associated with AFE.
  
  Conclusions
  
  Recommendation 1: Comparisons of AFE incidence estimates should be restricted to studies using similar methodology. The recommended approaches would be either population-based database studies using additional criteria to exclude false positive cases, or tailored data collection using existing specific population-based systems.
  
  
• Subjects:
  Cesarean Section Embolism, Amniotic Fluid Female Fetal Membranes, Premature Rupture Health Status Humans Incidence Pregnancy Pregnancy Complications Pregnancy Outcome Prenatal Care Risk Factors Women's Health

  More +
• Source:
  BMC Pregnancy Childbirth. 2012; 12:7.
• Document Type:
  Journal Article
• Place as Subject:
  Australia ; Europe ; United States
• Volume:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d56b4fb4f6885b3ff89084d5bba8af79dfb6dc3c8977d7282cdd6d4b7649a1b4
• Download URL:
  https://stacks.cdc.gov/view/cdc/7991/cdc_7991_DS1.pdf
• File Type:
  [PDF - 244.99 KB ]