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Semin Thromb Hemost 1998; 24(5): 479-484
DOI: 10.1055/s-2007-996043
Copyright © 1998 by Thieme Medical Publishers, Inc.

Serological and Immunohistochemical Diagnosis of Amniotic Fluid Embolism

Hidekazu Oi, Hiroshi Kobayashi, Yasuyuki Hirashima, Tatsuya Yamazaki, Takao Kobayashi, Toshihiko TeraoPrior to the commencement of this study, approval was obtained from the relevant Ethics Committees of Hamamatsu University School of Medicine. Proper consents were obtained from the patients or, in the case of deceased patients with AFE, from the patient's guardians. Informed consent for blood sampling was also obtained from all subjects.
  • *Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Publication Date:
06 February 2008 (online)

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Abstract

The purpose of this study was to evaluate whether serological assays and immunohistochemical staining, employing antibody TKH-2, are sensitive methods for the serological and histologic diagnosis of amniotic fluid embolism (AFE). TKH-2 is a sensitive antibody directed to sialyl Tn (STN), NeuAcα2-6GalNAc. Nineteen samples of maternal sera with clinical AFE and 120 control sera and 15 specimen of formalin-fixed, paraffin-embedded lung tissue sections were examined in this study. Tissue sections were stained using the streptavidin-biotin-immunoperoxidase method. The concentration of STN in serum was measured by an immunoradiometric competitive inhibition assay using the monoclonal antibody TKH-2 in a one-step procedure. Remarkable positive TKH-2 stainings were easily seen within the pulmonary vasculature in 14 of the 15 (93%) patients with AFE. The serum STN levels (mean ± SD) in patients with AFE (110.8 ± 48.1 U/ml) showed significantly higher concentrations compared with those of patients with non-AFE (17.3 ± 2.6 U/ml) (p <0.01). Seventeen of 19 sera (89%) were diagnosed as AFE by serum TRH-2 level. We conclude that both TKH-2 immunostaining and serum STN assay are sensitive methods to diagnose patients with AFE.

Keywords:

Amniotic fluid embolism - sialyl Tn - TKH-2 immunohistochemical stain - lung tissue

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