![]() The best option would be to opt for tile or bamboo flooring for your concrete patio. If you like the look of wood flooring, try a wood plank stamped concrete patio Outdoor Contracting creates this stamped and stained surface so the patio looks like it’s made from well-preserved antique wood. You can consider opting for one of these concrete patio ideas on a budget. How do you make a concrete patio look modern?Īns- There are ways to make your concrete patio look modern without spending a huge part of your saving on renovations.Choosing one of these modern concrete patio ideas on a budget will make your backyard a lively place for sitting and chit-chatting. You can choose to carpet it or build an outdoor turf. How can I make my concrete patio look better?Īns- There are multiple ways to make your concrete patio look better.You can consider this option if you do not want to renovate your concrete patio with tile flooring or any other idea. What are stamped concrete patio ideas on a budget?Īns- Stamped concrete patio ideas on a budget will add more designs, patterns, and shapes to your concrete floor.However, if you are finding simple concrete patio ideas on a budget, you can consider bamboo flooring, tile flooring, and concrete staining. Is there a way to revamp my concrete patio?Īns- Yes! There are plenty of ways to make your concrete patio look better.They create new translucent marble effects on your concrete patio to enhance its look. These stains can help you eliminate the uneven pattern on your concrete floor. Yes! We are talking about concrete staining with water or acid-based stains. If so, we have a solution to eliminating this problem from your backyard. These imperfections in your concrete patio can make you feel uncomfortable. No concrete floor is ever devoid of imperfections. There are more in store to help you pick the one that will suit your backyard. If you haven’t had your pick amongst the top three concrete patio ideas, don’t worry. So, why the wait? select your stamped concrete patio design today! Simple and Modern Concrete Patio Ideas on a Budget (3-6) Redoing your concrete patio with one of the stamped concrete patio ideas will enhance its look with various designs. They make your monotonous-looking silver concrete patio turn lively and beautiful. The stamped concrete patio ideas on a budget are affordable and cheap. Source 23.A stamped concrete patio idea for simple and modern concrete patio ideas on a budget Here are 28+ best concrete patio ideas that will make your backyard pretty. In the long run, concrete might be the most durable, cost-effective surface available. Maintenance on these floors is much less than it is on the materials they mimic. This makes it an excellent choice for interior floors.įor interior floor applications, it can be patterned and colored to resemble ceramic tile, natural stone like marble or granite, or even hardwood or laminate flooring planks. Because of its thermal mass, it is very energy efficient with respect to heating and cooling. There is no demolition and rebuilding because of termite damage or fires. Why? First, it usually only needs to be built once. ![]() ![]() Related: 23 Best Concrete Driveway Ideas and Designs Concrete is a Green, Sustainable Building MaterialĬoncrete is green. Finally, the entire surface is refinished with a polymer coat, textured or stamped to order, and sealed. ![]() This involves priming, reinforcing with a special repair fabric, applying an elastomeric base coat, and the coating with a polymer concrete mixture. The first step is to thoroughly clean the existing surface. If an existing concrete patio, driveway, walkway, or swimming pool deck is cracked or just bland-looking, it can easily be resurfaced at a fraction of the cost of removing the old and starting from scratch.Īlthough each situation is different and unique, the process is fairly straightforward. ![]() Custom logos or mosaics are available when working with a construction or installation designer. The number of colors and patterns with a custom imprinted concrete surface are limited only by the imagination. Natural stone and pavers require weeding but concrete joints don’t have that disadvantage. Unlike asphalt driveways or sidewalks that need an annual seal coating, concrete only requires periodic cleaning and sealing, every few years or so. With pavers, it’s necessary not only to do the prep work of trenching, compacting the soil, and spreading sand, but then each paver must by hand placed individually, carefully following the pattern, be it herringbone, basketweave, or stretcher bond. For example, compare that process to installing clay brick pavers. Concrete can be rapidly poured or pumped into place and finished after the concrete form is built. 23. X-Brace Side Table Concrete Top Under $30.Concrete is a Green, Sustainable Building Material.Re-Surfacing Existing Concrete Surfaces. ![]()
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![]() ![]() Serves residents of the Area 2 School District, which covers most of North Augusta and Belvedere in Aiken County. Open from 9:30 AM to 2:00 PM, Wednesday through Saturday. NeededįACEBOOK ~ Christ Central New Ellenton, SC Services Offered at New Ellenton: Food and Clothing Distribution Life Skills and Adult Education Youth After-School Education and Mentoring. Pantry Days/Hours 1st & 3rd Fridays ~ 10 am - 11 am 2nd & 4th Tuesdays 10 am - 11 am NO APPOINTMENTS NEEDED Valid I.D. Please call for additional information regarding the food pantry. Contact Richard Goudy, Director of Support Services. ![]() Open from 10:00 AM to 4:00 PM on Tuesday, Wednesday and Thursday, from 10:00 AM to 6:00 PM on Friday, and from 10:00 AM to 1:00 PM on the first and third Saturdays of the month. Serves residents of Aiken School District Areas 1, 4, and 5 (Only part of Beech Island is served.) Open for Client services from 11:00 AM to 3:00 PM, Monday through Friday. Get Help Call 211 for Essential Community Services | United Way 211 USDA Food & Nutrition Service (WIC) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) | Food and Nutrition Service ()Ģ11 Get Connected. Hunger Relief Organization | Feeding America GA Georgia Food Pantries | Food Banks, Food Pantries, Food Assistance in Georgiaįeeding America U.S. SC South Carolina Food Pantries | Food Banks, Food Pantries, Food Assistance in South Carolina The ATC blessing box is on campus on the backside of the Student Activities Center in the Quad. Here you can view a map of all blessing boxes in the area and search for one near you. Listing of Habitat for Humanity Blessing boxes. If you need an application or a renewal form mailed to you, please call 1-80.To submit an application or renewal via fax, send to (803) 734-2012.You may apply for SNAP and/or TANF benefits online, submit your completed application form in the secure, outside drop box at any county office, mail or fax your application. ![]() 9/2/2023 0 Comments Christian yu weight![]() ![]() "Have you not learned your lesson about Atlanta traffic yet?" I come to the end of a twisty I'm holding and let it fall where it may. I have to be at the salon in a little more than an hour." "I can hear your thoughts, and the answer is no. ![]() "But I didn't even say anything." He began to pout in contest. The expression on his face made it easy to tell what he was thinking, and as much as I wanted to proceed. He kissed his teeth and puckered his lips to the side, "First of all-" he started as I snapped my head around to debate him-forgetting just that quick that he literally had a hold of my hair, as the slight tug elicited a reflexive lip bite from me, and he definitely took notice, tugging a bit more, trying to unearth a stronger reaction. He looked a bit fear stricken, but smirked it off. ![]() "What was that?" I turned my head as much as I could with him still holding on to my hair. He took the fluffy strands and began doing a twist to the best of his ability, "Gotta learn how to do it at some point anyway." he mumbled to himself. At this point, I just needed it done so that we could head to the salon, "Okay, just do this one then." I unraveled one of the hair ties holding a patch of blown out hair that wasn't twisted yet. It's just going to unravel" Arguing with him about how to twist the blown out sections of MY hair was the equivalent of telling a 5 yr old how to do. "But you're twisting it the wrong way, Ian. I hope he takes care and takes □ all the time needed. Taking care of yourself and shutting out the world is sometimes the best and most needed thing but you should never have to apologize for it. Updated: I hope Christian gets the rest he needs. Whoever he ends up with is going to have quite a time □ Our boy is at 1million followers on Instagram □□□ Seriously skinny legend status and untouchable status lol. ![]() 9/2/2023 0 Comments Meld windows requires python![]() ![]() share/help/cs/meld/missing-functionality.page.share/help/cs/meld/keyboard-shortcuts.page.share/help/C/meld/resolving-conflicts.page.share/help/C/meld/missing-functionality.page.share/help/C/meld/keyboard-shortcuts.page.lib/python3.9/site-packages/meld/windowstate.py.lib/python3.9/site-packages/meld/vcview.py.lib/python3.9/site-packages/meld/vc/svn.py.lib/python3.9/site-packages/meld/vc/mercurial.py.lib/python3.9/site-packages/meld/vc/git.py.lib/python3.9/site-packages/meld/vc/darcs.py.lib/python3.9/site-packages/meld/vc/cvs.py.lib/python3.9/site-packages/meld/vc/bzr.py.lib/python3.9/site-packages/meld/vc/_vc.py.lib/python3.9/site-packages/meld/vc/_null.py.lib/python3.9/site-packages/meld/vc/_init_.py.lib/python3.9/site-packages/meld/vc/README.lib/python3.9/site-packages/meld/vc/COPYING.lib/python3.9/site-packages/meld/undo.py.lib/python3.9/site-packages/meld/ui/vcdialogs.py. ![]() lib/python3.9/site-packages/meld/ui/util.py.lib/python3.9/site-packages/meld/ui/statusbar.py.lib/python3.9/site-packages/meld/ui/recentselector.py.lib/python3.9/site-packages/meld/ui/pathlabel.py.lib/python3.9/site-packages/meld/ui/notebooklabel.py.lib/python3.9/site-packages/meld/ui/notebook.py.lib/python3.9/site-packages/meld/ui/msgarea.py.lib/python3.9/site-packages/meld/ui/listwidget.py.lib/python3.9/site-packages/meld/ui/historyentry.py.lib/python3.9/site-packages/meld/ui/gtkcompat.py.lib/python3.9/site-packages/meld/ui/gladesupport.py.lib/python3.9/site-packages/meld/ui/filebutton.py.lib/python3.9/site-packages/meld/ui/findbar.py.lib/python3.9/site-packages/meld/ui/emblemcellrenderer.py.lib/python3.9/site-packages/meld/ui/cellrenderers.py.lib/python3.9/site-packages/meld/ui/bufferselectors.py.lib/python3.9/site-packages/meld/ui/_init_.py.lib/python3.9/site-packages/meld/treehelpers.py.lib/python3.9/site-packages/meld/tree.py.lib/python3.9/site-packages/meld/task.py.lib/python3.9/site-packages/meld/style.py.lib/python3.9/site-packages/meld/sourceview.py.lib/python3.9/site-packages/meld/settings.py.lib/python3.9/site-packages/meld/recent.py.lib/python3.9/site-packages/meld/preferences.py.lib/python3.9/site-packages/meld/patchdialog.py.lib/python3.9/site-packages/meld/newdifftab.py.lib/python3.9/site-packages/meld/misc.py.lib/python3.9/site-packages/meld/menuhelpers.py.lib/python3.9/site-packages/meld/meldwindow.py.lib/python3.9/site-packages/meld/melddoc.py.lib/python3.9/site-packages/meld/meldbuffer.py.lib/python3.9/site-packages/meld/meldapp.py.lib/python3.9/site-packages/meld/matchers/myers.py.lib/python3.9/site-packages/meld/matchers/merge.py.lib/python3.9/site-packages/meld/matchers/helpers.py.lib/python3.9/site-packages/meld/matchers/diffutil.py.lib/python3.9/site-packages/meld/matchers/_init_.py.lib/python3.9/site-packages/meld/linkmap.py.lib/python3.9/site-packages/meld/iohelpers.py.lib/python3.9/site-packages/meld/gutterrendererchunk.py.lib/python3.9/site-packages/meld/filters.py.lib/python3.9/site-packages/meld/filediff.py.lib/python3.9/site-packages/meld/dirdiff.py.lib/python3.9/site-packages/meld/diffgrid.py.lib/python3.9/site-packages/meld/const.py.lib/python3.9/site-packages/meld/conf.py.lib/python3.9/site-packages/meld/chunkmap.py.lib/python3.9/site-packages/meld/build_helpers.py.lib/python3.9/site-packages/meld/actiongutter.py.lib/python3.9/site-packages/meld/accelerators.py.lib/python3.9/site-packages/meld/_init_.py.¦ ¦ ¦ ¦ pkg-plist: as obtained via: make generate-plist Expand this list (242 items) Collapse this list. The margins show location of changes for easy navigation, and it alsoįeatures a tabbed interface that allows you to open many diffs at once. The diff viewer lets you edit files in place (diffs updateĭynamically), and a middle column shows detailed changes and allows merges. Maintainer: Port Added: 23:36:40 Last Update: 17:18:38 Commit Hash: f699543 People watching this port, also watch:: freetype2, gnupg, lame, expat, glib Also Listed In: devel python License: GPLv2 Description: Meld is a GNOME visual diff and merge tool. Want a good read? Try FreeBSD Mastery: Jails (IT Mastery Book 15) All times are UTCģ.22.0,1 textproc =21 3.22.0,1 Version of this port present on the latest quarterly branch. FreshPorts - textproc/meld: GNOME visual diff and merge toolĪs an Amazon Associate I earn from qualifying purchases. ![]() ![]() ![]() Just FYI, basic Lambda sensor operation :ĭuring idle, the ECU will constantly run a rich/lean cycle on closed-loop control, usually under WOT conditions it will go open loop and enrich the mixture, during cruise it is once again closed-loop and will oscillate up/down.Ī cold sensor won't give any output voltage and nor will a dead one - this causes the ECU to try and enrich the mixture causing rich running.ĭuring the MoT on my Coupe one year, one of the Lambdas failed during the emissions test. Just another thought - have you tried disconnecting the +ve feed from the compressor clutch and feeding the clutch direct from the battery? That will prove the operation of the clutch at least. The generally accepted service life of a Lambda sensor is 10 years or 100k miles so the chances are renewing them and resetting the ECU will return things to normal operation. With the mileage at 133k on the last MoT in March, i'd suggest renewing the Lambda sensors and resetting the ECU and also running some Cataclean through the fuel system. It could be sensor 2 is unplugged or some other workaround has been used, assuming it has two sensors of course. If it has, i think you may have found the problem. Have you actually confirmed it has 2 sensors? If it is indeed the post-cat sensor it should follow what sensor 1 does but with a lower value. More worrying is the fact that the sensor 2 is showing 0.48V constantly. Until the sensors are hot enough (i presume they're heated on the Merc as they are on your Rover) they shouldn't give any voltage at all. The sensor 1 value that oscillates between 0.18 - 0.82V is correct for a hot engine under closed-loop control. Given it's not a Vee engine, i'd suggest the "sensor 2" value of a constant 0.48V is the post-cat sensor. How soon after a cold start is the reading available for the Lambda sensors Adrian? ![]() 9/2/2023 0 Comments Safe serve bartender class![]() ![]() Health and safety protocols for Blossom Music Festival reflect those of Live. The convenient online course & exam can be completed in about an hour – no more 3+ hour classes, not to mention trying to find parking and make it to the class on-time! Online Beverage Server Training is available 24/7, at a cost of only $25. Not a bad shack but the bartender, Jeff, was awful. Free Tram Service between parking lots and the Pavilion is available on a. If you fail the final exam you have one additional attempt to. PBSA trains thousands of bartenders in the ServSafe program each year in our brick and mortar bartending schools. The purpose of the certification is to ensure that all food service workers understand the issues surrounding food safety and ensure these food and beverage workers comply with. Pass the certification exam.You have 30 days to complete the course. ServSafe certification is a training program that was developed to maintain the standards and safety of the professional workers in the restaurant/service industry. Complete the TIPS alcohol certification course online at your own pace. Enroll in our class by clicking on one of the four 'Buy Now TIPS' buttons above. Show your printed certificate or pull up on your phone“works in exactly the same way as the ˜server cards issued by Delaware Alcohol & Tobacco Enforcement (D.A.T.E.) officers. Follow These Easy Steps Below to Enroll & get TIPS Certified. This online course replicates the information from the Office of the Alcoholic Beverage Control Commissioner (OABCC) at the traditional “in-person classes” but is available anytime, anywhere! Take the test from your computer or mobile device,and print your certificate the same day. The Online Alcoholic Beverage Server Training was developed by the Delaware Restaurant Association to meet the demand for quick & easy training options for all servers, bartenders, and those who handle alcohol in Delaware. Prepare yourself to handle these risks with responsible alcohol training from a trusted and experienced source, the National Restaurant Association. ![]() 9/2/2023 0 Comments Stripes club in atlanta![]() ![]() All while dining on some of the best food in Atlanta. ![]() Watch beautiful ladies peel off beaded gowns while dancing on bars and table tops Give new meaning to the term "best man" by throwing your friend's bachelor party here. Great cold beer prices and up-close, personal private dances are always on tap.Ītlanta Strip Clubs also serves up the ultimate Gentleman's club experience with The Cheetah and Pink Pony, These are the places many young professionals in Atlanta to let loose. Here you'll find lots of gorgeous girls getting the 5 o'clock hour off to a more-than-happy start. Fannies, the World Renowned Tattletale of Atlanta, and Oasis Good Time Emporium come to mind. ![]() Looking for something with a neighborhood bar feel? We have lots of unpretentious Atlanta strip clubs where the blue collar worker is always welcome. Atlanta strip clubs are definitely the place to party with music moguls, meet up and coming artists, and network in the entertainment business. ![]() While word of mouth is still one of the biggest promotions out there, strip club airplay is stronger than radio airplay. Atlanta strip club culture has influenced the commercial soundscape of Hip Hop today and Magic City, Club Onyx, and Follies are all known for discovering some of the best hip hop artists in the game. They are the places where hip hop royalty are made. In several strip clubs around Atlanta, you'll find more than just the typical strip club scene. No matter what your style, Atlanta has the club you will call home. Atlanta strip clubs and adult entertainment have many options from the high end upscale strip club to the smaller less expensive local club, with over 7,500 strip clubs nationally and more opening each year. Strip clubs are one of the fastest growing venues of entertainment in America. With our complete list of Atlanta strip clubs, this is your one stop for a mind-blowing night out in the ATL. Browse through the list of Atlanta’s Strip Clubs, search for the hottest girls, find out who has Atlanta's wildest bachelor parties, and never miss a Special Event. This is the ONLY place that has all of the gorgeous ladies of Atlanta on one site. Surrounding cities have since followed their lead and sadly continue to do so, destroying what was formerly known as ”The Strip Club Capital of America.” The city that started the whole strip club war was Marietta when it fought against the grand Taj Mahal and Boomers in the mid-90's, eventually shutting both clubs down. Under the new ordnance, the clubs must stop alcohol sales at 2am Monday to Saturday and 12am on Sundays. Pink Pony and Follies had former pouring times of Monday through Friday from 9 a.m. Both strip clubs are among the few in Atlanta that open on Sunday and are now facing a rollback on last call. Pink Pony and Follies, both located in Brookhaven, are now being targeted by their city council. We reached out to Mardi Gras only to be told the strip club was “closed indefinitely”.īut these clubs were not the only ones feeling push back from their city. Hundreds of people including dancers, bartenders, waitresses, bouncers, managers, housemoms, cooks, and valets woke up jobless with no real warning. After an arduous 13 year fight against the city, the Georgia Supreme Court’s ruling shut down all four clubs on Wednesday, Sept 5th. The newest ones to be taken down include Mardi Gras, Flashers, Dollhouse, and Coronet Club, all which resided in unincorporated Sandy Springs. Recent closings and new ordinances have many people asking “ What the hell is happening to Atlanta’s strip clubs?” What was once a thriving industry in Atlanta is now slowly being runoff by city council members under the guise that strip clubs bring crime. Helping you find your way to the hottest parties in town is Atlanta Strip. Previously Known as the Strip Club Capital of America, Atlanta is home to over 30 of the finest Gentlemen’s Clubs you’ll ever have the pleasure of experiencing. Proudly servicing Atlanta for the past 10 years. Like us on Atlanta strip clubs Facebook and follow us on our Atlanta Strip Club Twitter so you’ll never miss a special event. Rate and review your strip club experience. Book VIP strip Club reservations and parties. Scroll through the Atlanta strip clubs featuring “real time” events and accurate info. Welcome to, the best source for strip clubs in Atlanta. ![]() 9/1/2023 0 Comments Herowarz download size![]() ![]() The gameplay of a fantastic rpg adventure offers you a world of combats and fights. Dive into this incredible world to save power and influence, and stay connected to know more! Dozens of heroes to play with. Hero wars mod apk offers users brilliant features and extraordinary functions to experience in this deadly arena of dominion. Enjoy this invincible hero game with all skills and powers free with god mode to explore rare rewards. So free shopping to unlock and purchase free accessories. Unlocked levels and modes, the campaign against several enemies and army, forge your guilds and proper training equipment that makes it possible. So offering in this mod unlimited money to use it for battles and pvp, unlock all superheroes and skillset, powers and upgrades, boost and enhanced combat abilities, etc. Unlocking new heroes and skills, however, requires money. To cope up ultimately with every issue and detail, you need to fend off the enemies and battle bosses, which require power-ups and boosts. These grand pvp arenas and matches against the archdemon and his evil army are not the end, but the grand pvp against multiplayer online has its own charm. Being addictive and smooth, this game brings users into its context, so you want more of it. ![]() Hero wars mod apk has its own style and charm, which brings you under its umbrellas. Explore this fantastic fantasy game of adventure. Grand arena, rewards, skills, and power need to be unlocked while also collecting heroes and upgrading them to leave a legacy behind. Jump straight in this rpg adventure to defeat the intentions and power of the goblin by overtaking everything. Dominate the world of dominion and show the world the invincible protector who is willing to sacrifice his life for the reputation. However, hero wars mod apk also brings iconic pvp arena and multiplayer matches against online players. Bring him down to misery by achieving rare items and gems and winning battlespower up your soldiers and upscale their skills to deal with boss fights. Forge a guild by recruiting and training your army of heroes to overtake the evil intention of the archdemon. Face off in arenas the skilled battles and pvp matches. You will collect heroes and unlock dozens of characters on the way as needed, collect rewards, unlock skills, and combat abilities. This rpg fantasy game brings the pleasure of interacting with giant enemies and army attacks, defending your kingdom, and fending off these people. Save dominion from foreign attacks and overtakes all the dominance of the place. Test your skills and become the invincible hero of your world. There are many heroes and influential people who want to fight against his evil intentions. Archdemon, with his mighty army, invaded your world known as dominion. Widely popular rpg offering the most uplifted battles and grand arena to show off your dominance and power comes to your command. Hero wars is a fantasy rpg gameplay that is extremely addictive and comes with various challenges to test your power and skillsoffering you the most stylish pvp arenas and warfares against raid bosses. Nexters global ltd has brought out this magnificent battle gameplay. ![]() 9/1/2023 0 Comments Rocky paw patrol ears![]() This costume is, at the time of writing, the top-reviewed and top-selling PAW Patrol Chase Costume at. He has skills as a Police Pup, Super Spy, Tracker, and Traffic Cop. ![]() “Chase is on the case!” Chase is the rather serious German Shepherd pup. (As an Amazon Associate I may earn a small commission from qualifying purchases made through links on this page, at no additional cost to you. AND, the specialized skills for each pup make playing PAW Patrol an easy thing for creative kids! DRESSING UP as the pups is even better! PAW PATROL COSTUMES FOR KIDS The episode themes are appropriate for children, focusing on teamwork and good citizenship. The language is decent, and the characters are respectful and kind to each other (no mouthing off, sarcasm, etc.). PAW Patrol is a great show for kids, in my opinion. His pup house turns into a firetruck, and he has water canons and in his pup pack.) (For example, Marshall is the Fire Rescue pup. They perform rescues for and protect the citizens (animal and human) of a shoreline community called Adventure Bay.Įach of the pups has their own special rescue skill, their own rescue pup-house-turn-vehicle, and their own customized “Pup Pack” with tools they can use for their rescues. PAW Patrol is an animated kids TV show by Spin Master Entertainment. The general story line is that there is a boy named Ryder who runs a team of (talking) rescue pups called the PAW Patrol. Very briefly, before we jump in to all things PAW Patrol dress up, a quick explanation for those of you who are maybe shopping for a gift for a grandchild or friend’s child who apparently “really likes PAW Patrol”, but you don’t know much about it. You’ve come to the right place! I’ve done some digging around through reviews and customer comments, and will be showcasing the top-reviewed and most loved PAW Patrol Costumes for Kids today. ![]() And you’re looking for the best PAW Patrol Costumes for kids! If you HAVE heard of it, then my guess is you are likely more than just a little bit familiar (to put it mildly) with the names of Ryder, Chase, Marshall, Rocky, Skye, Zuma, Rubble, Everest, and Tracker.Īnd if you’ve found your way to this web page, it’s likely because your kids love PAW Patrol so much that dressing up as one of the pups (or Ryder) is something they’d absolutely love. ![]() If you haven’t heard of it, you’re likely not a parent to a young child. ![]() 9/1/2023 0 Comments Amniotic fluid embolism pdf![]() ![]() ![]() 19 More recent population-based studies have reported a decrease in case fatality rate from AFE (13.3% for Canada, 21.6% for the United States, 24.0% for the United Kingdom, and 44.0% for Sweden), justifying the view that this condition should not be considered as uniformly lethal. In Clark’s national registry, the maternal fatality rate was 61% for the period 1988–1994. In China, regional studies reported that AFE was the second cause of maternal death.ġn 1979, Morgan, 11 based on 272 cases of AFE published in the English literature, reported a maternal fatality rate of 86%. Overall, in the last 10 years, AFE accounted for 5.0–15.0% of all maternal deaths in developed countries (5.3% for the United Kingdom, 10.9% for Canada, 13.1% for Australia, and 13.7% for the United States), being the leading cause of maternal death in Australia, the second cause of maternal death in the United States, the third cause of maternal death in France and Poland, and the second cause of direct maternal death in the United Kingdom. In developing countries, the reported maternal mortality ratios ranged between 1.8–5.9 per 100,000 deliveries. The maternal mortality ratio associated with AFE ranged between 0.5–1.7 deaths per 100,000 live births or deliveries (0.5 for Sweden and the United Kingdom, 0.7 for Canada, 1.5 for Australia, and 1.0–1.7 for the United States). Additional research will be needed to evaluate why the incidence of AFE is over 3 times higher in North America than in Europe. On the other hand, it is possible that AFE is over-diagnosed for medicolegal reasons, since this complication is widely considered to be an unavoidable cause of maternal death. The true incidence of AFE, however, is difficult to determine because the diagnosis of this syndrome remains one of exclusion, with possible underreporting of nonfatal cases. 38, 42, 43 There were no available data on incidence of AFE in other regions of the world. 43 Based on those studies, the pooled estimated incidence of AFE would be 1 in 15,200 deliveries (95% confidence interval, 1 in 13,900 to 1 in 16,700 deliveries) in North America 24, 36, 40 and 1 in 53,800 deliveries (95% CI, 1 in 48,800 to 1 in 59,900 deliveries) in Europe. Details of these studies are provided in the supplementary appendix (available online at According to recent large population-based studies, 24, 36, 38, 40, 42, 43 the incidence of AFE, which includes both fatal and nonfatal cases, ranges between 1 in 12,953 deliveries in the United States, 40 to 1 in 56,500 in the United Kingdom. 6 Forty studies 2, 6– 44 had data on the incidence of AFE and/or associated maternal and perinatal mortality around the world. In 1941, Steiner and Lushbaugh, 2 based on the occurrence of 3 cases of fatal AFE in the first 24,200 deliveries at the New Chicago Lying-In Hospital, estimated the incidence of AFE to be about 1 in 8000 deliveries (maternal mortality ratio of 12.4 deaths per 100,000 deliveries), but subsequently realized that this was an overestimation since no more cases were observed in the next 26,000 deliveries (corrected maternal mortality ratio of 6.0 deaths per 100,000 deliveries). This review critically examines, from the best available evidence, the current knowledge regarding the epidemiology, pathogenesis, pathophysiology, diagnosis, and treatment of AFE. Moreover, several aspects on this condition remain a subject of controversy. 3 Evidence on AFE, however, has been mainly based on individual case reports, autopsy series, or uncontrolled case series due to the low frequency of the condition. Understanding of the pathogenesis of AFE has increased substantially in the last two decades since this disorder was recognized as 1 of the main causes of maternal mortality in the United States. The presence of fetal debris in the pulmonary blood vessels of a mother who had died suddenly in labor was first described by Meyer 1 in 1926, but it was not until 1941 that death following sudden collapse during labor or in the immediate postpartum period was attributed to AFE. Amniotic fluid embolism (AFE) is a rare and often fatal obstetric condition, characterized by sudden cardiovascular collapse, altered mental status, and disseminated intravascular coagulation (DIC). ![]() |
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