Amniotic fluid embolism managed with success during labour: report of a severe clinical case and review of literature.
BACKGROUND
AFE (amniotic fluid embolism) is widely known as a disastrous rapid-progressing clinical entity. The incident ranges from 1:800 to 1:8,000. The mortality rate reaches 61-86%. Neonatal survival is reported at 70%.


METHODS
We describe the case of a healthy 29-year old primigravida developing amniotic fluid embolism during labour. Acute respiratory failure and hypotension combined with seizures were the initial symptoms. The patient under went an urgent caesarean section with extreme blood loss, complicated by disseminated coagulopathy.


RESULTS
A total hysterectomy was performed due to profuse bleeding. Aggressive management was practiced with continuous transfusion of blood products and administration of vasocopressors.


CONCLUSIONS
Amniotic fluid embolism or anaphylactoid syndrome of pregnancy is a life-threatening condition. Diagnosis is one of the exclusion. Its management is very difficult and requires quick management and cooperation of physicians from different specialties.
Peitsidou
A
A
Obstetrics and Gynecology Department, Alexandra General Hospital, Athens, Greece.
Peitsidis
P
P
Tsekoura
V
V
Spathi
A
A
Tzaneti
A
A
Samanta
E
E
Siampalioti
G
G
Kioses
E
E
D000208:Acute Disease; D000328:Adult; D016913:Blood Component Transfusion; D016063:Blood Loss, Surgical; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002585:Cesarean Section; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000628:therapy; D004298:Dopamine / Q000627:therapeutic use; D004619:Embolism, Amniotic Fluid / Q000175:diagnosis / Q000628:therapy*; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D005169:Factor VIII / Q000627:therapeutic use; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007044:Hysterectomy; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D012131:Respiratory Insufficiency / Q000209:etiology
D002316:Cardiotonic Agents; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen; D004298:Dopamine