Amniotic fluid embolism induces uterine anaphylaxis and atony following cervical laceration

Naoaki Tamura, Hisashi Nagai, Hidyuki Maeda, Ryo Hei Kuroda, Makoto Nakajima, Atsuko Igarashi, Naohiro Kanayama, Ken Ichi Yoshida

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Amniotic fluid embolism (AFE) is a rare, high-risk obstetric complication primarily found in the lungs and potentially related to anaphylaxis. Tryptase release from the mast cell reflects anaphylaxis. Case report and findings: A female, aged over 40 years, presented with uterine atony and lethal hemorrhage after induced vaginal labor. Cervical laceration was accompanied by severe hemorrhage. Stromal edema and myometrial swelling were consistent with uterine atony. Alcian blue staining and zinc coproporphyrin immunostaining disclosed AFE, which was more prominent in the uterus than in the lungs. Tryptase immunostaining was diffuse and prominent around the activated mast cells (halos) in the uterus, including the cervix. Similar distribution of findings on the AFE markers, tryptase halos, complement receptor C5aR, and atony in the uterus suggested the causality of AFE to anaphylaxis, complement activation and atony. It is probable that disseminated intravascular coagulation (DIC), induced by AFE, uterine atony and cervical laceration, caused the lethal hemorrhage. It is likely that AFE, in association with cervical laceration, induces uterine anaphylaxis, complement activation, atony, DIC and lethal hemorrhage.

Original languageEnglish
Pages (from-to)65-68
Number of pages4
JournalGynecologic and Obstetric Investigation
Volume78
Issue number1
DOIs
Publication statusPublished - 2014 Jul

Keywords

  • Amniotic fluid embolism
  • Anaphylaxis
  • Cervical laceration
  • Mast cell
  • Tryptase
  • Uterine atony

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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  • Cite this

    Tamura, N., Nagai, H., Maeda, H., Kuroda, R. H., Nakajima, M., Igarashi, A., Kanayama, N., & Yoshida, K. I. (2014). Amniotic fluid embolism induces uterine anaphylaxis and atony following cervical laceration. Gynecologic and Obstetric Investigation, 78(1), 65-68. https://doi.org/10.1159/000360537