Clark et al listed criteria for the diagnosis of amniotic fluid embolism (AFE) suitable for use in research studies. These are based on a review of international criteria. The authors are from Baylor College of Medicine in Houston, National Institute of Child Health and Human Development, Columbia University, CDC, Banner Health in Phoenix and the University of Texas Medical Branch in Galveston.
Classic triad of AFE:
(1) hemodynamic compromise
(2) respiratory compromise
(3) disseminated intravascular coagulation (DIC)
Uniform diagnostic criteria:
(1) one or more of the following:
(1a) sudden onset of cardiorespiratory arrest
(1b) sudden onset of hypotension (systolic blood pressure < 90 mm Hg) AND respiratory compromise (dyspnea, cyanosis, peripheral capillary oxygen saturation < 90%).
(2) evidence of DIC using the ISTH score modified for pregnancy and excluding false positive diagnoses (dilutional coagulopathy, shock-related consumptive coagulopathy)
(3) clinical onset during labor or within 30 minutes of the placental delivery
(4) absence of fever (temperature >= 38°C) during labor
