title: Unresponsive primipara after rupture of membranes.
abstract: Amniotic fluid embolism, also called anaphylactoid syndrome of pregnancy, is a rare but severe problem in obstetrics. It occurs in 8/100,000 births and the maternal mortality is up to 90%. We report the case of a patient with amniotic fluid embolism who was transferred to our hospital. The initial presentation was an unresponsive patient after spontaneous rupture of the membranes. The massive hypotension and coagulopathy as well as fetal bradycardia of 60 bpm led, after stabilisation of the mother, to an emergency caesarean section. The neonate expired hours later, despite neonatological intensive care. During the operation, we had to deal with massive bleeding due to the coagulopathy. Through interdisciplinary teamwork including Bakri postpartum balloon insertion through the obstetrics team, uterine artery embolism by the interventional radiologists and transfusion of blood products, the maternal life was saved and the patient was discharged 9 days after admission.
authors.affiliation: Department of Obstetrics and Gynecology, Universitätsspital Basel, Basel, Switzerland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Buechel
authors.affiliation: Department of Anesthesiology, Universitätsspital Basel, Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Berset
authors.affiliation: Department of Anesthesiology, Universitätsspital Basel, Basel, Switzerland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Lehmann
authors.affiliation: Department of Obstetrics and Gynecology, Universitätsspital Basel, Basel, Switzerland.
authors.forename: Olav
authors.initials: O
authors.lastname: Lapaire
mesh_terms: D000328:Adult; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002585:Cesarean Section / Q000379:methods; D004619:Embolism, Amniotic Fluid / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000628:therapy; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome