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[Pathomechanisms, signs, symptoms and management of amniotic fluid embolism (author's transl)].

The rare, acute and dramatic event of amniotic fluid embolism is increasing in relative importance as a cause of maternal mortality. Recent findings based on the estimation and characterization of circulating fibrin, fibrinogen content and fibrin-fibrinogen degradation products indicate that the coagulation disorder is caused by intravascular coagulation and extensive fibrinolysis and fibrinogenolysis. The program of treatment consists of: 1. Management of the acute respiratory insufficiency syndrome by early intubation and ventilation with positive end-expiratory pressure (PEEP). 2. Intensive therapy of shock and rapid restoration of blood volume with blood transfusion (fresh whole blood) and infusion of other fluids. 3. Treatment of the coagulation disorder with fibrinogen, antifibrinolytic agents (aprotinin--Trasylol), platelet transfusion and fresh frozen plasma.