Lalos O, von Schoultz B
Int J Gynaecol Obstet. 1977;15(1):48-53. doi: 10.1002/j.1879-3479.1977.tb00643.x.
Amniotic fluid embolism (AFE) is a rare but dramatic obstetric complication. In this study, the pathogenesis of AFE and the disorders of coagulation and fibrinolysis and postmortem gross pathologic and histologic findings resulting from it are reviewed. The 2 case histories examined in this report exemplify different clinical courses of amniotic fluid embolism. In the first case, there was a predominant activation of the coagulation system, with a fatal outcome. In the second case, generalized fibrinolysis dominated, and the woman survived. Finally, the authors wish to emphasize that the administration of fibrinogen is an incorrect approach to the management of this syndrome. A combination of Macrodex and heparin might be effective in preventing the formation of microthrombi, but increased fibrinolysis has to be treated by a sufficiently high dose of fibrinolytic inhibitors.
羊水栓塞（AFE）是一种罕见但严重的产科并发症。在本研究中，对羊水栓塞的发病机制、凝血和纤溶紊乱以及由此导致的死后大体病理和组织学发现进行了综述。本报告中检查的2个病例史例证了羊水栓塞的不同临床病程。在第一个病例中，凝血系统占主导激活，结果致命。在第二个病例中，全身性纤溶占主导，该女性存活。最后，作者希望强调，给予纤维蛋白原是治疗该综合征的错误方法。右旋糖酐和肝素联合使用可能对预防微血栓形成有效，但必须用足够高剂量的纤溶抑制剂治疗增强的纤溶。
