Chest computed tomography of a patient revealing severe hypoxia due to amniotic fluid embolism: a case report.
BACKGROUND
Amniotic fluid embolism is one of the most severe complications in the peripartum period. Because its onset is abrupt and fulminant, it is unlikely that there will be time to examine the condition using thoracic computed tomography (CT). We report a case of life-threatening amniotic fluid embolism, where chest CT in the acute phase was obtained.


METHODS
A 22-year-old Asian Japanese primiparous woman was suspected of having an amniotic fluid embolism. After a Cesarean section for cephalopelvic disproportion, her respiratory condition deteriorated. Her chest CT images were examined. CT findings revealed diffuse homogeneous ground-glass shadow in her bilateral peripheral lung fields. She was therefore transferred to our hospital. On admission to our hospital's intensive care unit, she was found to have severe hypoxemia, with SpO2 of 50% with a reservoir mask of 15 L/min oxygen. She was intubated with the support of noninvasive positive pressure ventilation. She was successfully extubated on the sixth day, and discharged from the hospital on the twentieth day.


CONCLUSIONS
This is the first case report describing amniotic fluid embolism in which CT revealed an acute respiratory distress syndrome-like shadow.
Imanaka
Hideaki
H
Department of Emergency and Critical Care, The University of Tokushima Graduate School, Kuramoto Tokushima, 770-8503, Japan. imanakah@clin.med.tokushima-u.ac.jp.
Takahara
Bunji
B
Yamaguchi
Harutaka
H
Nakataki
Emiko
E
Mano
Akiko
A
Inui
Daisuke
D
Oto
Jun
J
Nishimura
Masaji
M