Amniotic Fluid Embolism, Pulmonary Hypertension
Conditions
Keywords
amniotic fluid entering the bloodstream, blood volume of amniotic fluid, Amniotic fluid embolism
Brief summary
This study was conducted to investigate whether the use of tourniquet after delivery of the fetus could reduce the amount of amniotic fluid entering the bloodstream and thus reduce the incidence of intraoperative adverse events.
Detailed description
Amniotic fluid embolism (AFE) is a rare complication specially to obstetrics.When amniotic fluid enters the maternal circulation , a sudden onset of a series of pathophysiologic changes such as pulmonary hypertension, hypoxemia, circulatory failure, disseminated intravascular coagulation, and multiorgan failure may occur. Routinely, the typical AFE triad is uneasy to discover, and nonspecific adverse reactions such as irritability, chills, chest tightness and shortness of breath, transient drop in blood pressure, and nausea and vomiting are often seen during delivery of the fetus and placenta. All of the above symptoms may suggest that the amniotic fluid has entered into the bloodstream. In clinical anesthesia, investigators observed that women with placenta praevia and placenta implantation were less likely to suffer these nonspecific symptoms after delivery of the fetus compared with women with normal pregnancies.The investigators speculated it might be related to the fact that obstetricians used tourniquets to reduce intraoperative hemorrhage in the former, blocking venous return to the lower uterine segments to reduce the inflow of amniotic fluid into the uterus. Therefore, this study was conducted to investigate whether the use of tourniquet after delivery of the fetus could reduce the amount of amniotic fluid entering the bloodstream and thus reduce the incidence of intraoperative adverse events.
Interventions
PROCEDUREtourniquet binding of cervical
The procedure will be performed by surgeons with rich experience in clinical work
Sponsors
First People's Hospital of Chenzhou
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
1. Single pregnancy 2. Be in good health, with no high blood pressure or heart disease during pregnancy 3. Without placenta previa and placenta implantation 4. No abdominal adhesions, suitable for operation 5. Signed informed consent by the pregnant woman and her family
Exclusion criteria
1. Serious coagulation abnormality 2. Preoperative severe cardiac, cerebral, pulmonary, hepatic, renal and other important organs insufficiency and electrolyte abnormality combined with placenta praevia or placenta implantation 3. Multiple pregnancies 4. Previous history of abdominal surgery 5. Intraoperative drug allergy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| sTn | before the fetus is delivered,after the fetus is delivered,before the puerpera is sent back to the ward | sTn refers to meconium and mucin extracted from amniotic fluid. The presence of sTn in the patient's serum is a diagnostic method that can directly prove that mucin derived from amniotic fluid has entered the maternal circulation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| HR MAP | before the fetus is delivered,after the fetus is delivered,before the placenta is delivered,after the placenta is delivered,after releasing the tourniquet,before the puerpera is sent back to the ward | Measurement of HR by patient monitor and MAP by placing an arterial puncture catheterization. |
| SPO2,PaO2,PaCO2 | before the fetus is delivered,after the fetus is delivered,before the placenta is delivered,after the placenta is delivered,after releasing the tourniquet,before the puerpera is sent back to the ward | the respiratory parameters in arterial blood gas |
| Thrombelastogram(TEG) | before the fetus is delivered,before the puerpera is sent back to the ward | Thrombelastography (TEG) is an indicator of the dynamic changes of blood coagulation. It can evaluate thrombelastography and compensate for the failure of routine examinations to reflect the fibrinolytic system and platelet function. |
| Adverse events | perioperatively | Irritability, chills, chest tightness and shortness of breath, transient drop in blood pressure, and nausea and vomiting |
| Hemorrhage | before the puerpera is sent back to the ward, 2 hours after the puerpera back to ward | The using of tourniquets can reduce intraoperative hemorrhage. The postpartum hemorrhage reflects the coagulation function of patients. |
Countries
China
Contacts
Primary ContactYingying Zhou
Backup ContactYao Chen
Outcome results
None listed