{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:33:41Z","timestamp":1784691221146,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,2,12]],"date-time":"2015-02-12T00:00:00Z","timestamp":1423699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["RP\u2010PG\u20100608\u201010038"],"award-info":[{"award-number":["RP\u2010PG\u20100608\u201010038"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the incidence, risk factors, management and outcomes of amniotic\u2010fluid embolism (<jats:styled-content style=\"fixed-case\">AFE<\/jats:styled-content>) over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A population\u2010based cohort and nested case\u2013control study using the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> Obstetric Surveillance System (<jats:styled-content style=\"fixed-case\">UKOSS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> hospitals with obstetrician\u2010led maternity units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All women diagnosed with <jats:styled-content style=\"fixed-case\">AFE<\/jats:styled-content> in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> between February 2005 and January 2014 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0120) and 3839 control women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective case and control identification through <jats:styled-content style=\"fixed-case\">UKOSS<\/jats:styled-content> monthly mailing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Amniotic\u2010fluid embolism, maternal death or permanent neurological injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total and fatal incidence of <jats:styled-content style=\"fixed-case\">AFE<\/jats:styled-content>, estimated as 1.7 and 0.3 per 100\u00a0000, respectively, showed no significant temporal trend over the study period and there was no notable temporal change in risk factors for <jats:styled-content style=\"fixed-case\">AFE<\/jats:styled-content>. Twenty\u2010three women died (case fatality 19%) and seven (7%) of the surviving women had permanent neurological injury. Women who died or had permanent neurological injury were more likely to present with cardiac arrest (83% versus 33%, <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001), be from ethnic\u2010minority groups (adjusted odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 2.85, 95% confidence interval [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.02\u20138.00), have had a hysterectomy (unadjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.49, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.02\u20136.06), had a shorter time interval between the <jats:styled-content style=\"fixed-case\">AFE<\/jats:styled-content> event and when the hysterectomy was performed (median interval 77\u00a0minutes versus 248\u00a0minutes, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.0315), and were less likely to receive cryoprecipitate (unadjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.30, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.11\u20130.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is no evidence of a temporal change in the incidence of or risk factors for <jats:styled-content style=\"fixed-case\">AFE<\/jats:styled-content>. Further investigation is needed to establish whether earlier treatments can reverse the cascade of deterioration leading to severe outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13300","type":"journal-article","created":{"date-parts":[[2015,2,13]],"date-time":"2015-02-13T10:19:41Z","timestamp":1423822781000},"page":"100-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":98,"title":["Incidence, risk factors, management and outcomes of amniotic\u2010fluid embolism: a population\u2010based cohort and nested case\u2013control study"],"prefix":"10.1111","volume":"123","author":[{"given":"KE","family":"Fitzpatrick","sequence":"first","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Tuffnell","sequence":"additional","affiliation":[{"name":"Bradford Teaching Hospitals NHS Foundation Trust Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJ","family":"Kurinczuk","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181fdfb11"},{"issue":"1","key":"e_1_2_6_3_1","first-page":"1","article-title":"Saving mothers\u2019 lives: reviewing maternal deaths to make motherhood safer: 2006\u20132008. 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