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Steiner, P.E. and Lushbaugh, C.C. (1941) Maternal pulmonary embolism by amniotic fluid as a cause of obstetric shock and unexpected deaths in obstetrics. Journal of the American Medical Association, 117, 1245-1254.

has been cited by the following article:

• TITLE: Amniotic fluid embolism: literature review and an integrated concept of pathomechanism

  AUTHORS: Mieczysław Uszyński

  KEYWORDS: Amniotic Fluid Embolism; Amniotic Cells, Tissue Factor; Leukotriens; Disseminated Intravascular Coagulation; Pulmonary Vasoconstriction

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.1 No.4, November 21, 2011

  ABSTRACT: Literature concerning procoagulant activity of the amniotic fluid and pathomechanism of amniotic fluid embolism (AFE) was surveyed and a new concept of its pathogenesis, called the integrated concept of AFE, was presented. According to this concept, two components of the amniotic fluid are involved: (i) apoptosis-affected amniotic cells showing a special role in the initiation of disseminated intravascular coagulation (DIC) and (ii) leukotrienes (formerly called slow-reacting substances), inducing bronchial and pulmonary vascular smooth muscle contraction. Although each of these components initiates a different pathogenic pathway, they both lead to the formation of a mechanical barrier on blood flow through the lungs (amniotic debris + microemboli) and/or functional barrier (pulmonary vasoconstriction). An old dilemma, concerning indications for heparin therapy in AFE was recalled in the light of the new concept.