Administration of blood components is considered the first line of treatment for correcting
coagulopathy associated with AFE. Since DIC is frequently associated with severe
hemorrhage, transfusion of packed red blood cells is a priority in order to maintain oxygen
delivery to the tissues. Specific laboratory coagulation abnormalities are treated with
transfusion of fresh frozen plasma, platelets, and/or cryoprecipitate. Cryoprecipitate is
particularly useful, because it can be used administered to replenish clotting factors in lieu of
fresh frozen plasma. In addition, since cryoprecipitate contains fibronectin, it could facilitate
the removal of cellular and particulate matter, such as amniotic fluid debris, from the blood
via the monocyte/macrophage system.46,131 Recently, recombinant activated factor VIIa hasbeen used to manage severe DIC resistant to conventional blood product replacement in
women with AFE.132,133 Uterine bleeding in a woman already delivered can be controlled
by massage and use of intravenous oxytocin. If uterine bleeding is unresponsive to these
methods, manual exploration to look for fragments of retained placenta or membranes or a
search for cervical or uterine lacerations needs to be considered. If bleeding is profuse and
pharmacological intervention is unsuccessful, a hysterectomy may be necessary.