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Eur J Obstet Gynecol Reprod Biol. 2017 Apr;211:33-36. doi: 10.1016/j.ejogrb.2017.01.050. Epub 2017 Jan 23.

Reproductive decisions after the diagnosis of amniotic fluid embolism.

Author information

1
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
2
Amniotic Fluid Embolism Foundation, Vista, CA, United States.
3
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States. Electronic address: gadildy@bcm.edu.

Abstract

OBJECTIVE:

This study aims to describe the subsequent reproductive outcomes in women who either correctly or incorrectly were diagnosed with amniotic fluid embolism (AFE).

STUDY DESIGN:

Medical records were obtained, abstracted and reviewed by authors with extensive experience in critical care obstetrics. Telephone interviews of all survivors were conducted to determine obstetrical and contraceptive history. A subgroup underwent further telephone interview to address subsequent reproductive decisions.

RESULTS:

By November 2015, 116 medical records of patients diagnosed with AFE were reviewed. Patients who had undergone hysterectomy (n=26), died (n=9), or developed Sheehan's syndrome (n=1) at the time of the original event were excluded from the present analysis. Of the remaining 80 women, 30% (24/80) had subsequently conceived and 32.5% (26/80) patients or their partners had undergone permanent sterilization. At the time of this report, 66% (21/32) of registry participants were categorized to have had AFE and 34% (11/32) as not likely AFE or indeterminate.

CONCLUSIONS:

The syndrome of AFE is over-diagnosed. Women diagnosed with AFE who survive conceive another pregnancy less frequently than US women over similar time intervals and often choose a permanent sterilization method, whether or not they actually had AFE, largely out of fear of AFE recurrence.

KEYWORDS:

Amniotic fluid embolism; Contraception; Diagnosis; Maternal mortality; Sterilization

PMID:
28192732
DOI:
10.1016/j.ejogrb.2017.01.050
[Indexed for MEDLINE]

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