Amniotic fluid embolism and management of coagulopathy: A case report with successful outcome

Author:

Tay Jun Hoe1ORCID,Goy Raymond Wee Lip1,Sng Ban Leong1

Affiliation:

1. Department of Women’s Anaesthesia, KK Women’s and Children’s Hospital, Singapore

Abstract

Amniotic fluid embolism (AFE) is a rare and potentially catastrophic condition unique to pregnancy. Presentation may range from subtle clinical events to sudden and fatal maternal cardiorespiratory arrest, with a reported incidence of 2–6 in 100,000 deliveries and mortality of 15–60%. Management should include immediate high-grade resuscitation for AFE presenting as cardiac arrest, involvement of multidisciplinary team, provision of adequate ventilator and circulatory support, treatment of coagulopathy precipitated by AFE, and immediate delivery of the foetus in cases of cardiac arrest. The following case report involves a patient with suspected AFE post-induction of labour with favourable maternal and neonatal outcome in our local setting. The management of coagulopathy in AFE is further discussed, including use of massive transfusion protocols, pharmacological agents and recombinant factor VIIa.

Publisher

SAGE Publications

Subject

General Medicine

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