Open AccessSevere maternal morbidity and mortality from amniotic fluid embolism in the Netherlands
Author(s) -
STOLK KOEN H.,
ZWART JOOST J.,
SCHUTTE JOKE,
VAN ROOSMALEN JOS
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2012.01442.x
Subject(s) - medicine , amniotic fluid embolism , obstetrics , odds ratio , amniotic fluid , embolism , incidence (geometry) , confidence interval , pregnancy , maternal death , population , gynecology , fetus , surgery , genetics , physics , environmental health , optics , biology
We 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.