Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-16T00:47:19.876Z Has data issue: false hasContentIssue false

Chapter 19 - Air Embolism Related to Sex in Pregnancy and the Postpartum

from Section 2 - Specific Issues

Published online by Cambridge University Press:  09 November 2022

Dan Farine
Affiliation:
Mount Sinai Hospital, Toronto
Pablo Tobías González
Affiliation:
Hospital Universitario Infanta Cristina de Parla, Madrid
Get access

Summary

Air embolism is acute embolism resulting from vaginal insufflation. It was first reported in 1936. There is no definite report of its incidence, but has been described in 18 mortalities out of 20 million pregnancies. When air is introduced under pressure, it travels through the dilated cervical canal and beneath the amniotic membranes, to enter the subplacental sinuses. Once air enters the venous drainage of the uterus, it reaches the inferior vena cava, and from there to the right side of the heart. Patients with venous air embolism (VAE) may present with a wide variety of symptoms. The most serious manifestation of VAE is out-of-hospital cardiac arrest. Laboratory abnormalities vary according to the severity of the embolism but lack specificity. The first line of treatment is advising pregnant females against orogenital sex with air insufflation. Accurate diagnosis is the key for managing VAE. Management starts with administration of 100% oxygen, then turning the patient onto her left side in a head-down position. In case of cardiovascular collapse, closed-chest compression is used to remove air trapped in the right side of the heart. Hyperbaric oxygen therapy has been proved to be an effective therapy as well.

Type
Chapter
Information
Sex and Pregnancy
From Evidence-Based Medicine to Dr Google
, pp. 138 - 143
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Heid, O. O.. A strange death trap in pregnancy from air embolism. Oeff Health Service 1936;A2:720–2.Google Scholar
Ragan, W. D.. Antepartum air embolism. J Indiana State Med Assoc 1981;1:30–2.Google Scholar
Bray, P., Myers, R. A. M., Cowley, R. A.. Orogenital sex as a cause of nonfatal air embolism in pregnancy. Obstet Gynecol 1985;61: 653–7.Google Scholar
Fyke, F. E., Kazmier, F. J., Harms, R. W.. Venous air embolism: life threatening complication of orogenital sex during pregnancy. Am J Med 1985;78:333–6.Google Scholar
Kaufman, B. S., Kaminsky, S. J., Rackow, E. C., et al. Adult respiratory distress syndrome following orogenital sex during pregnancy. Crit Care Med 1987;15:703–4.Google Scholar
Kim, C. S., Liu, J., Kwon, J. Y., Shin, S. K., Kim, K. J.. Venous air embolism during surgery, especially cesarean delivery. J Korean Med Sci 2008;23:753–61.Google Scholar
Truhlar, A., Cerny, V., Dostal, P., et al. Out-of-hospital cardiac arrest from air embolism during sexual intercourse: case report and review of the literature. Resuscitation 2007;73:475–84.CrossRefGoogle ScholarPubMed
Batman, P. A., Thomlinson, J., Moore, V. C., et al. Death due to air embolism during sexual intercourse in the puerperium. Postgrad Med J 1998;74:612–13.Google Scholar
Jones, C., Chan, C., Farine, D.. Sex in pregnancy. Can Med Assoc J 2011;183:815–18.Google Scholar
Nelson, P. K.. Pulmonary gas embolism in pregnancy and the puerperium. Obstet Gynecol Surv 1960;15:449–81.Google Scholar
Varon, J., Laufer, M. D., Sternbach, G. L.. Recurrent pneumoperitoneum following vaginal insufflation. Am J Emerg Med 1991;9:447–8.CrossRefGoogle ScholarPubMed
Fries, C. C., Levowitz, B., Adler, S., et al. Experimental gas embolism. Ann Surg 1957;145:4651.Google Scholar
Aronson, M. E., Nelson, P. K.. Fatal air embolism in pregnancy resulting from an unusual act. Obstet Gynecol 1967;30:127–30.Google Scholar
Bajanowski, T., Köhler, H., Du Chesne, A., et al. Proof of air embolism after exhumation. Int J Legal Med 1999;112:27.CrossRefGoogle Scholar
Pedal, I., Moosmayer, A., Mallach, H. J., et al. Air embolism or putrefaction? Gas analysis findings and their interpretation. Z Rechtsmed 1987;99:151–67.Google Scholar
Pierucci, G., Gherson, G.. Further contribution to the chemical diagnosis of gas embolism. The demonstration of hydrogen as an expression of “putrefactive component.” Zacchia 1969;5:595603.Google Scholar
Rushton, D. I., Dawson, I. M.. The maternal autopsy. J Clin Pathol 1982;35:909–21.Google Scholar
Orebaugh, S. L., Grenvik, A.. Air embolisation. In Shoemaker, W. C., Grenvik, A., eds. Textbook of Critical Care, 4th ed. Philadelphia: W. B. Saunders, 2000: 1155–62.Google Scholar
Fatteh, A., Leach, W. B., Wilkinson, C. A.. Fatal air embolism in pregnancy resulting from orogenital sex play. Forensic Sci Int 1973;2:247–50.Google Scholar
Clark, S. L.. New concepts of amniotic fluid embolism: a review. Obstet Gynecol Surv 1990;45:360–8.CrossRefGoogle ScholarPubMed
Clark, S. L., Montz, F. J., Phelan, J. P.. Hemodynamic alterations associated with amniotic fluid embolism: a reappraisal. Am J Obstet Gynecol 1985;151:617–21.Google Scholar
Nolan, J. P., Deakin, C. D., Soar, J., Böttiger, B. W., Smith, G., European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. Resuscitation 2005;67(Suppl 1):S39–86.Google Scholar
Alvaran, S. B., Toung, J. K., Graff, T. E., et al. Venous air embolism. Comparative merits of external cardiac massage, intracardiac aspiration, and left lateral decubitus position. Anesth Analg 1978;57:166–70.Google Scholar
Bernhardt, T. L., Goldmann, R. W., Thombs, P. A., et al. Hyperbaric oxygen treatment of cerebral air embolism from orogenital sex during pregnancy. Crit Care Med 1988;16:729–30.CrossRefGoogle ScholarPubMed
Mack, L. E.. Here’s how vaginal embolisms happen. 2017. www.romper.com/p/how-do-vaginal-embolisms-happen-its-a-rare-but-possible-occurrence-60636 (accessed April 23, 2021).Google Scholar
What you need to know about pregnant sex. 2015. www.foxnews.com/health/what-you-need-to-know-about-pregnant-sex (accessed April 23, 2021).Google Scholar
Air embolism. Last updated May 10, 2022. https://en.wikipedia.org/wiki/Air_embolism (accessed April 23, 2021).Google Scholar
Lindsay, J.. Getting freaky: will you really die if someone blows air into your vagina? 2018. https://metro.co.uk/2018/10/25/getting-freaky-will-you-really-die-if-someone-blows-air-into-your-vagina-8050287/ (accessed April 23, 2021).Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×