morphine and Embolism

A 3-day-old premature infant with meconium peritonitis, periventricular leukomalacia, and pulmonary hypertension died with respiratory insufficiency. An autopsy disclosed intravascular squamous cells in the lungs, brain, liver, pancreas, and kidneys. Numerous pulmonary capillaries and arterioles were occluded by squamous cells, accounting for pulmonary hypertension. Brain parenchyma surrounding occluded cerebral vessels showed infarct and gliosis. A mediastinal lymph node filled with squamous cells alluded to the mechanism by which these cells from the peritoneal cavity likely entered the bloodstream--namely, via diaphragmatic pores connecting with lymphatics. Thus, disseminated intravascular meconium rarely may complicate meconium peritonitis and have devastating consequences.

Topics: Embolism; Fatal Outcome; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Premature, Diseases; Meconium; Peritonitis; Pregnancy; Pregnancy Complications; Vascular Diseases

Our purpose was to determine the acute-phase central hemodynamic and respiratory effects of raw, filtered, filtered and boiled, and meconium-containing amniotic fluid.. Pregnant goats (Capra hircus) in the last one third of pregnancy were given freshly collected autologous amniotic fluid in a volume of 2.5 ml/kg of body weight. Observations were then made at 10, 30, 60, 120, and 180 minutes after amniotic fluid embolism. Pulmonary artery catheters and femoral artery lung water catheters were placed for specimen and data collection.. Marked pressor responses were observed in both the pulmonary and systemic circulations with all amniotic fluid infusions. The pressor response was similar with raw, filtered, and filtered and boiled amniotic fluid. The pressor response seen with amniotic fluid containing meconium was significantly greater than that seen with the other forms. No significant effects were observed on cardiac or respiratory function except in the meconium group, where transient left ventricular dysfunction was accompanied by an acute increase in extravascular lung water and dysoxia.. The Capra hircus model is appropriate for the further study of amniotic fluid embolism. The acute pressor effects are transient and involve both the systemic and pulmonary circulations. Left ventricular dysfunction and dysoxia were observed only with embolism of amniotic fluid containing meconium.

Topics: Amniotic Fluid; Animals; Disease Models, Animal; Embolism; Female; Goats; Hemodynamics; Meconium; Pregnancy; Respiratory Mechanics

Topics: Abruptio Placentae; Animals; Arteries; Blood Circulation; Cats; Dogs; Embolism; Embolism, Amniotic Fluid; Female; Humans; Meconium; Microscopy; Motion Pictures; Pregnancy; Pulmonary Circulation; Rabbits; Thromboembolism; Veins

Topics: Afibrinogenemia; Amniotic Fluid; Animals; Embolism; Female; Fibrinolysis; Haplorhini; Meconium; Pregnancy; Pregnancy, Animal; Thromboplastin

Topics: Amniotic Fluid; Animals; Blood Coagulation; Blood Pressure; Cardiac Output; Dogs; Dye Dilution Technique; Electrocardiography; Embolism; Embolism, Amniotic Fluid; Female; Heart Function Tests; Hemodynamics; Heparin; Meconium; Pharmacology; Pregnancy; Pregnancy, Animal; Pulmonary Circulation; Pulmonary Embolism; Research; Vagotomy; Vascular Resistance

Topics: Amniotic Fluid; Blood; Blood Coagulation Disorders; Embolism; Embolism, Amniotic Fluid; Female; Fibrinolysis; Humans; Infant, Newborn; Meconium; Obstetric Labor Complications; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Hematologic; Prothrombin Time; Thrombelastography; Thromboplastin

Topics: Amniotic Fluid; Animals; Body Fluids; Dogs; Embolism; Embolism, Amniotic Fluid; Female; Meconium; Pregnancy; Pulmonary Embolism; Research

Topics: Animals; Embolism; Humans; Infant, Newborn; Injections, Intravenous; Lung; Meconium; Rabbits

Topics: Amniotic Fluid; Embolism; Female; Humans; Infant, Newborn; Meconium; Pregnancy; Pulmonary Embolism; Thrombosis

Topics: Blood Coagulation; Blood Coagulation Disorders; Embolism; Female; Fibrin; Hemorrhagic Disorders; Heparin; Humans; Infant, Newborn; Meconium; Placenta; Pregnancy; Shock

Topics: Anticoagulants; Blood Coagulation; Embolism; Humans; Infant, Newborn; Meconium; Patient Discharge

Topics: Amniotic Fluid; Embolism; Humans; Infant, Newborn; Meconium; Minnesota