Research on Diagnosis, Treatment, Prediction, and Prevention involving Amniotic Fluid Embolism from the Viewpoint of Angioedema

2017 Fiscal Year Final Research Report

• Project/Area Number: 15H04983
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Obstetrics and gynecology
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: Kanayama Naohiro 浜松医科大学, 医学部, 理事 (70204550)
• Co-Investigator(Kenkyū-buntansha): 谷口 千津子 浜松医科大学, 医学部附属病院, 特任助教 (20397425) ; 安立 匡志 浜松医科大学, 医学部附属病院, 診療助教 (40749446) ; 田村 直顕 浜松医科大学, 医学部, 助教 (90402370) ; 内田 季之 浜松医科大学, 医学部附属病院, 講師 (90570234)
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 羊水塞栓症 / 血管浮腫 / 子宮弛緩症 / フィブリノーゲン / Ｃ１インヒビター / ＤＩＣ / 線溶亢進

Outline of Final Research Achievements

We investigated 614 and 46 patients with serums and tissues respectively for Amniotic Fluid Embolism (AFE) Registry Program. AFE was classified into uterine and cardiopulmonary collapse type, in which we proposed clinical and tissue diagnostic criteria of former type to Perinatology Committee, Japan Society of Obstetrics and Gynecology. Myometrium involving AFE was affected by strong expression of bradykinin type 1 receptor, which may indicate aggravation of uterine edema coincided with anaphylactoid reaction. In addition, we found decreased expression of uterine contractile associated proteins in those uterine tissue. These findings can cause severe uterine atony refractory to uterotonics in AFE. Mast cell degranulation was found in AFE patients’ bronchioles and pulmonary artery, which revealed anaphylactoid reaction even in lung. Our multiple center study group found great improvement of uterine contraction after administration of C1 inhibitor concentration.

Free Research Field

産婦人科