new_n_lost
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A 27-year-old woman is giving birth. During the birth, the placental membranes tear and amniotic fluid is expressed into a lacerated cervical vein.
Which of the following is the woman most likely to experience immediately following this event?
A. Hemiplegia
B. Placental abruption
C. Renal failure
D. Respiratory distress
E. Splinter hemorrhages
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| mytime
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D. Thank u.
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| silver
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D. Respiratory distress
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| jean robert
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| SmokyWaters
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D
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| new_n_lost
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mytime wrote:
D. Thank u.
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| new_n_lost
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The correct answer is D.
Respiratory distress immediately follows amniotic fluid embolism as the emboli consisting of squamous cells, lanugo, and mucus deposit in the pulmonary microcirculation, producing numerous tiny pulmonary infarcts. The dramatic respiratory distress may also reflect the action of prostaglandins and other bioactive compounds present in high concentrations in the amniotic fluid embolus.
Hemiplegia (choice A) would reflect an ischemic injury to one hemisphere of the cerebrum or the brainstem. A venous embolus would not produce such an insult.
Placental abruption (choice B) is partial, premature separation of the placental disc from the endometrium. Although abruption may occur in this setting, it is not a result of an amniotic fluid embolism.
There are numerous causes of renal failure (choice C); the most likely ones in the peripartum interval include eclampsia, hypovolemic shock, and ascending infections. Amniotic fluid embolism would be expected to produce severe dyspnea well before shock and renal failure might arise.
Splinter hemorrhages (choice E) are small hemorrhages seen on toes and fingers due to a shower of microemboli arising in the arterial circulation. Amniotic fluid emboli arise in the veins and deposit in the lungs.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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