Amniotic fluid embolus.
A case report of a 27-yr-old healthy patient for Caesarean section under epidural anaesthesia is presented. The patient suffered an acute cardiorespiratory collapse when the infant's head was being delivered through the anterior abdominal wall. The patient remained cyanosed after proper tracheal intubation and pulmonary ventilation with 100% O2. Hypotension was difficult to treat but returned to normal 25 min after the event. A pulmonary artery catheter inserted three hours after the event showed normal pressures and a high cardiac output. The patient suffered permanent neurological damage. The differential diagnosis is discussed and current concepts of the aetiology and management of amniotic fluid embolism reviewed.
Noble
W H
WH
Department of Anaesthesia, St. Michael's Hospital, Toronto, Ontario.
St-Amand
J
J
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001794:Blood Pressure / Q000502:physiology; D002585:Cesarean Section / Q000009:adverse effects; D003937:Diagnosis, Differential; D004619:Embolism, Amniotic Fluid / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*