title: Successful recovery from delayed amniotic fluid embolism with prolonged cardiac resuscitation.
abstract: Amniotic fluid embolisms (AFE) are one of the most fatal complications of pregnancy. We describe a case of AFE that occurred 2 h after vaginal delivery at 41 weeks of gestation. The diagnosis of AFE was made by symptoms of dyspnea, coagulopathy, and severe hypotension. ZnCP-1, the characteristic component of meconium, was elevated in the serum. Cardiac compressions after repeated cardiac arrests were required during the initial 2 h of resuscitation. Primary resuscitation was performed with airway management and aggressive fluid management, including infusion of 33 units of red cell concentrates and 57 units of fresh frozen plasma. The patient recovered without any aftereffects. This case report warrants that AFE should be considered when coagulopathy and dyspnea are observed during the postpartum period.
authors.affiliation: Department of Gynecology and Obstetrics, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Hosono
authors.forename: Noriomi
authors.initials: N
authors.lastname: Matsumura
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Matsuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Sato
authors.forename: Ikuo
authors.initials: I
authors.lastname: Konishi
mesh_terms: D000328:Adult; D016913:Blood Component Transfusion; D016887:Cardiopulmonary Resuscitation; D004619:Embolism, Amniotic Fluid / Q000628:therapy*; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D013997:Time Factors; D016896:Treatment Outcome