? ? ? ? (Amniotic Fluid Embolism,AFE)

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? ? ? ?(Amniotic Fluid Embolism,AFE)
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• ????????????????????????????????????(DIC)??????
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• 1.??????? 1/80001/80000
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• 2.???6086
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• ???????1996-2000????????(1/10?)
• ?? 1996 1997 1998 1999 2000
• ?? 63.9 63.6 56.2 58.7 53.0
• ?? 29.2 38.3 28.1 26.2 28.9
• ?? 86.4 80.4 75.5 79.7 67.2
• ???? 4.4 6.2 4.1 6.4 5.6
• (???????2003(1)

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• 1984-1998 ??????38?
• ????30? (78.9) ???8? (21.1)
• ??? 122902
• ??? 3.9/10?
• ???????15

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• Herman Welsch Bavaria
• 1983-1988 1989-1994
  1995-2000
• ????? 95 9
  71
• ???? 6 3
  9
• ???(1/10?) 0.8 0.4 0.5

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• ???? 4 10.4
• ?????? 9 23.7
• ??????? 11 28.9
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• ???? 4 10.4
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(No Transcript)
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• ????70???????????11?????????????19????????
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• 2.???
• 3.???????

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(No Transcript)
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Amniotic Fluid Embolism Signs and Symptoms

• Clark et al, Amniotic fluid embolism analysis of
  a national registry. Am J Obstet Gynecol
  19951721158-1169

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Amniotic Fluid Embolism Diagnosis

• ?????????
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• 1.??????????????????
• 2.??????????
• 3.?????????????????????,???????????????????
• 4.???? ?????????
• ????
• 5.?????

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????
21
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• ????????????????????,???????????????
• 1.?????????????????????
• ????????,??500mg,????10002000mg,??????????????
  ?????,??????????????????DIC,?????????,????????????
  ??????

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• 2.????????????,???????,??????????????????????,???
  ?????,?????????????

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• 3.???????
• (1)????????????,???????????,??????????????????0.2
  50.5g??1025????20ml,?????
• (2)????????????????????,?????????????????3060mg?
  ?25????20ml,?????
• (3)??????????,????????????,?????????0.51mg,????,
  ?1015????,??????
• (4)???????????,???20mg??10????250ml,?????

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• 4.????????????????,????????????DIC???????????????
  ????
• (1)?????
• (2)?????
• (3)???????

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• 5.??DIC
• ??????,????????,??????
• ????,?????????????????????

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• 6.???????????????,??????(???)0.20.4mg???25????2
  0ml,????,???46??????,????lt1.2mg???????4080mg,???
  ?,??????,???????????????

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• 7.??????????????????????,????????????????,??????
  ?????????,?????????????????,???????,?????????????1
  7ml?,???????????????????????,???????????????

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• There are no data that any type of intervention
  improves maternal prognosis with amniontic fluid
  embolism
• ---------Williams Obstetrics 21st edition
  662

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• 9.????

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