Amniotic fluid embolism and management of coagulopathy: A case report with successful outcome

Amniotic fluid embolism (AFE) is a rare and potentially catastrophic condition unique to pregnancy. Presentation may range from subtle clinical events to sudden and fatal maternal cardiorespiratory arrest, with a reported incidence of 2–6 in 100,000 deliveries and mortality of 15–60%. Management sho...

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Bibliographic Details
Published inProceedings of Singapore healthcare Vol. 29; no. 3; pp. 198 - 202
Main Authors Tay, Jun Hoe, Goy, Raymond Wee Lip, Sng, Ban Leong
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.09.2020
Sage Publications Ltd
SAGE Publishing
Subjects
Amniotic fluid
Case reports
Embolisms
Emergency medical care
Heart attacks
Pregnancy complications
obstetrics anaesthesiology
coagulopathy
Amniotic fluid embolism
massive transfusion protocol
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Summary:Amniotic fluid embolism (AFE) is a rare and potentially catastrophic condition unique to pregnancy. Presentation may range from subtle clinical events to sudden and fatal maternal cardiorespiratory arrest, with a reported incidence of 2–6 in 100,000 deliveries and mortality of 15–60%. Management should include immediate high-grade resuscitation for AFE presenting as cardiac arrest, involvement of multidisciplinary team, provision of adequate ventilator and circulatory support, treatment of coagulopathy precipitated by AFE, and immediate delivery of the foetus in cases of cardiac arrest. The following case report involves a patient with suspected AFE post-induction of labour with favourable maternal and neonatal outcome in our local setting. The management of coagulopathy in AFE is further discussed, including use of massive transfusion protocols, pharmacological agents and recombinant factor VIIa.
ISSN:2010-1058
2059-2329
DOI:10.1177/2010105820929723