Bibliographic record
Abstract
Although a rare event, occurring in 1/25000–80000 deliveries, amniotic fluid embolism (AFE) is perhaps the most catastrophic of all obstetric complications. In the developed world, AFE accounts for approximately 10% of all direct maternal deaths, rating it among the top three causes. The prominence of AFE is accounted for by the fact that, although it is a rare condition, the mortality rate is 30–80% and, even among survivors, the hypoxic insult is so profound that many have permanent neurological damage. There is some evidence that prompt resuscitation and intensive care lead to improved intact survival. Pathophysiology The pathophysiology of AFE is poorly understood. It has been suggested that many of the hallmarks of AFE are similar to those of septic shock and anaphylaxis. Furthermore, it has been established that amniotic fluid commonly enters the maternal circulation without ill effect in most women. It is postulated that in certain susceptible women, fetal cells and other vasoactive substances, such as prostaglandins and leukotrienes, may initiate, via endogenous mediators, a complex pathophysiological cascade similar to that seen in anaphylactic and septic shock. The sequelae are as follows: • Initially, there is acute pulmonary arteriolar obstruction and hypertension. This is transient and soon followed by left ventricular failure resulting in profound hypotension. • Next, there is severe hypoxia as a result of ventilation–perfusion imbalance. This, together with the hypotension, produces a generalised hypoxia, often leading to seizures. It is this profound and sustained hypoxia that is responsible for the neurological damage in survivors.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.022 | 0.010 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".