[Complicated but successful resuscitation after amniotic fluid embolism].
A 33-year-old woman, gravida IV, para III with unexplained polyhydramnios was admitted to give birth at 29 weeks of pregnancy. Directly after the spontaneous breaking of the membranes, asystolia occurred. Following emergency resuscitation the sinus rhythm returned. Upon the relaparotomy due to a large filling requirement and increasing abdomen size, 'crush' lesions to the spleen and liver were visible; following this a splenectomy was carried out and tampons applied to the liver. After seven months the patient had slight residual symptoms; three weeks after his birth her son was transferred in good condition to another hospital. Amniotic fluid embolism is a rare complication of pregnancy with often serious complications for mother and child. The diagnosis is based on the clinical symptoms of cardiac arrest or sudden profound shock, acute respiratory failure, and/or disseminated intravascular coagulation, occurring in most cases during or soon after delivery, in the absence of an alternative cause (in particular primary cardiopulmonary causes). If the clinical picture deviates from the expected post-resuscitation course alternative diagnoses or resuscitation injuries must be considered.
Bouman
E A
EA
Afd. Anesthesiologie, Universitair Medisch Centrum, Postbus 85.500, 3508 GA Utrecht.
Gutiérrez y Leon
J A
JA
van der Salm
P C
PC
Christiaens
G C
GC
Bruinse
H W
HW
Broeders
I A
IA
D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002585:Cesarean Section; D004619:Embolism, Amniotic Fluid / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications*; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007813:Laparotomy; D006831:Polyhydramnios / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D013156:Splenectomy; D016896:Treatment Outcome