Gottschalk Antje
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Kaiserswerther-Diakonie, Florence-Nightingale-Krankenhaus, Kreuzbergstraße 79, 40489, Düsseldorf, Deutschland.
Anaesthesiologie. 2025 Jun;74(6):399-408. doi: 10.1007/s00101-025-01545-2.
Amniotic fluid embolism is one of the leading causes of direct maternal deaths worldwide. It cannot be predicted. Pregnant women who have undergone a cesarean section, a multiple pregnancy, a placental implantation disorder, polyhydramnion, the need for drug-induced labor and a maternal age ≥ 35 years have a significantly increased risk of developing a peripartum amniotic fluid embolism. The diagnostics of amniotic fluid embolism are purely clinical and include a triad of sudden onset of hypoxia and hypotension, followed by coagulopathy. A causal treatment is not yet known. Treatment must be immediate and is symptom oriented. Decisive for the prognosis and the survival of the mother and neonate are the rapid diagnosis and immediate interdisciplinary treatment. When an amniotic fluid embolism is suspected more personnel must be commandeered without delay as many treatment steps must be carried out simultaneously.
羊水栓塞是全球孕产妇直接死亡的主要原因之一。它无法预测。接受过剖宫产、多胎妊娠、胎盘植入障碍、羊水过多、药物引产以及产妇年龄≥35岁的孕妇发生围产期羊水栓塞的风险显著增加。羊水栓塞的诊断完全基于临床，包括缺氧和低血压突然发作，随后出现凝血病这一组三联征。目前尚无因果性治疗方法。治疗必须立即进行，且以症状为导向。对母亲和新生儿的预后及生存起决定性作用的是快速诊断和立即进行多学科治疗。当怀疑发生羊水栓塞时，必须立即调集更多人员，因为许多治疗步骤必须同时进行。
