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Amniotic Fluid Embolism During Emergent Cesarean Section at 25 Weeks of Gestation: A Case Report

Received: 31 May 2015     Accepted: 12 June 2015     Published: 30 June 2015
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Abstract

Amniotic fluid embolism (AFE) is a rare but fatal obstetric emergency, characterized by sudden cardiovascular collapse, dyspnea or respiratory arrest and altered mentality, disseminated intravascular coagulation (DIC). It can lead to severe maternal morbidity and mortality, but the prediction of its occurrence and treatment are very difficult. We report a case of AFE during emergent Cesarean section at 25 weeks of gestation for high vaginal bleeding, caused by placenta praevia totally recovered, in a 36 years old woman having a history of two c-section and carring bichorial biamniotic twin pregnancy. Sudden dyspnea, hypotension, signs of pulmonary edema and DIC were developed during Cesarean section, and cardiac arrest followed after these events. The course of these events was so rapid and catastrophic, which was consistent with AFE and disseminated intravascular coagulation (DIC).Thus, we report this case precisely and review pathophysiology, diagnosis, treatment of AFE by referring to up-to-date literatures.

Published in Journal of Gynecology and Obstetrics (Volume 3, Issue 4)
DOI 10.11648/j.jgo.20150304.12
Page(s) 77-82
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Complications, Amniotic Fluid Embolism, Cardiac Arrest, Surgery, Cesarean Section

References
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[2] Steiner P, Luschbaugh C. Maternal pulmonary emboli by amniotic fluid. JAMA. 1991;117:1245–1254.
[3] Morgan M. Amniotic fluid embolism. Anaesthesia. 1989;34:20–32.
[4] Clark SL, Hankins GD, Dudley DA, Dildy GA, Porter TF. Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol. 1995;172:1158–1169.
[5] Kim BI, Paek SH, Rho WS, Lee SP, Cho SK, Lee SH. Amniotic fluid embolism during dilatation and curettage in a second trimesteric missed aborted pregnant patient. Korean J Anesthesiol. 1997;33:778–783.
[6] Haines J, Wilkes RG. Non-fatal amniotic fluid embolism after cervical suture removal. Br J Anaesth.2003;90:244–247.
[7] Abenhaim HA, Azoulay L, Kramer MS, Leduc L. Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Am J Obstet Gynecol. 2008;199:49.e1–49.e8.
[8] Lewis G. The confidential enquiry into maternal and child health (CEMACH) The seventh report on confidential enquiries into maternal deaths in the United Kingdom. London: CEMACH; 2007. Saving mothers' lives: reviewing maternal deaths to make motherhood safer--2002-2005.
[9] Clark SL. New concepts of amniotic fluid embolism: a review. Obstet Gynecol Surv. 1990;45:360–368.
[10] Shechtman M, Ziser A, Markovits R, Rozenberg B. Amniotic fluid embolism: early findings of transesophageal echocardiography. Anesth Analg. 1999;89:1456–1458.
[11] Lockwood CJ, Bach R, Guha A, Zhou XD, Miller WA, Nemerson Y. Amniotic fluid contains tissue factor, a potent initiator of coagulation. Am J Obstet Gynecol. 1991;165:1335–1341.
[12] Stolte L, van Kessel H, Seelen J, Eskes T, Wagatsuma T. Failure to produce the syndrome of amniotic fluid embolism by infusion of amniotic fluid and meconium into monkeys. Am J Obstet Gynecol.1967;98:694–697.
[13] Hammerschmidt DE, Ogburn PL, Williams JE. Amniotic fluid activates complement. A role in amniotic fluid embolism syndrome? J Lab Clin Med. 1984;104:901–907.
[14] Resnik R, Swartz WH, Plumer MH, Benirschke K, Stratthaus ME. Amniotic fluid embolism with survival. Obstet Gynecol. 1976;47:295–298.
[15] 15. Ho CH, Chen KB, Liu SK, Liu YF, Cheng HC, Wu RC. Early application of extracorporeal membrane oxygenation in a patient with amniotic fluid embolism. Acta Anaesthesiol Taiwan. 2009;47:99–102.
Cite This Article
  • APA Style

    Khalid Guelzim, Youssef Benabdejlil, Adil Chennana, Mohammed Moutaouakil, Adil Boudhas, et al. (2015). Amniotic Fluid Embolism During Emergent Cesarean Section at 25 Weeks of Gestation: A Case Report. Journal of Gynecology and Obstetrics, 3(4), 77-82. https://doi.org/10.11648/j.jgo.20150304.12

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    ACS Style

    Khalid Guelzim; Youssef Benabdejlil; Adil Chennana; Mohammed Moutaouakil; Adil Boudhas, et al. Amniotic Fluid Embolism During Emergent Cesarean Section at 25 Weeks of Gestation: A Case Report. J. Gynecol. Obstet. 2015, 3(4), 77-82. doi: 10.11648/j.jgo.20150304.12

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    AMA Style

    Khalid Guelzim, Youssef Benabdejlil, Adil Chennana, Mohammed Moutaouakil, Adil Boudhas, et al. Amniotic Fluid Embolism During Emergent Cesarean Section at 25 Weeks of Gestation: A Case Report. J Gynecol Obstet. 2015;3(4):77-82. doi: 10.11648/j.jgo.20150304.12

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  • @article{10.11648/j.jgo.20150304.12,
      author = {Khalid Guelzim and Youssef Benabdejlil and Adil Chennana and Mohammed Moutaouakil and Adil Boudhas and Jaouad Kouach and Mohammed Oukabli and Chafiq Haimeur and Driss Moussaoui and Mohammed Dehayni},
      title = {Amniotic Fluid Embolism During Emergent Cesarean Section at 25 Weeks of Gestation: A Case Report},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {3},
      number = {4},
      pages = {77-82},
      doi = {10.11648/j.jgo.20150304.12},
      url = {https://doi.org/10.11648/j.jgo.20150304.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20150304.12},
      abstract = {Amniotic fluid embolism (AFE) is a rare but fatal obstetric emergency, characterized by sudden cardiovascular collapse, dyspnea or respiratory arrest and altered mentality, disseminated intravascular coagulation (DIC). It can lead to severe maternal morbidity and mortality, but the prediction of its occurrence and treatment are very difficult. We report a case of AFE during emergent Cesarean section at 25 weeks of gestation for high vaginal bleeding, caused by placenta praevia totally recovered, in a 36 years old woman having a history of two c-section and carring bichorial biamniotic twin pregnancy. Sudden dyspnea, hypotension, signs of pulmonary edema and DIC were developed during Cesarean section, and cardiac arrest followed after these events. The course of these events was so rapid and catastrophic, which was consistent with AFE and disseminated intravascular coagulation (DIC).Thus, we report this case precisely and review pathophysiology, diagnosis, treatment of AFE by referring to up-to-date literatures.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Amniotic Fluid Embolism During Emergent Cesarean Section at 25 Weeks of Gestation: A Case Report
    AU  - Khalid Guelzim
    AU  - Youssef Benabdejlil
    AU  - Adil Chennana
    AU  - Mohammed Moutaouakil
    AU  - Adil Boudhas
    AU  - Jaouad Kouach
    AU  - Mohammed Oukabli
    AU  - Chafiq Haimeur
    AU  - Driss Moussaoui
    AU  - Mohammed Dehayni
    Y1  - 2015/06/30
    PY  - 2015
    N1  - https://doi.org/10.11648/j.jgo.20150304.12
    DO  - 10.11648/j.jgo.20150304.12
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 77
    EP  - 82
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20150304.12
    AB  - Amniotic fluid embolism (AFE) is a rare but fatal obstetric emergency, characterized by sudden cardiovascular collapse, dyspnea or respiratory arrest and altered mentality, disseminated intravascular coagulation (DIC). It can lead to severe maternal morbidity and mortality, but the prediction of its occurrence and treatment are very difficult. We report a case of AFE during emergent Cesarean section at 25 weeks of gestation for high vaginal bleeding, caused by placenta praevia totally recovered, in a 36 years old woman having a history of two c-section and carring bichorial biamniotic twin pregnancy. Sudden dyspnea, hypotension, signs of pulmonary edema and DIC were developed during Cesarean section, and cardiac arrest followed after these events. The course of these events was so rapid and catastrophic, which was consistent with AFE and disseminated intravascular coagulation (DIC).Thus, we report this case precisely and review pathophysiology, diagnosis, treatment of AFE by referring to up-to-date literatures.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • Department of Gynecology-Obstetric - Military Training Hospital Med V, Rabat, Morocco

  • Department of Gynecology-Obstetric - Military Training Hospital Med V, Rabat, Morocco

  • Department of Gynecology-Obstetric - Military Training Hospital Med V, Rabat, Morocco

  • Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco

  • Department of Pathological Anatomy, Military Training Hospital Med V, Rabat, Morocco

  • Department of Gynecology-Obstetric - Military Training Hospital Med V, Rabat, Morocco

  • Department of Pathological Anatomy, Military Training Hospital Med V, Rabat, Morocco

  • Department of Anesthesiology and Critical Care, Military Training Hospital Med V, Rabat, Morocco

  • Department of Gynecology-Obstetric - Military Training Hospital Med V, Rabat, Morocco

  • Department of Gynecology-Obstetric - Military Training Hospital Med V, Rabat, Morocco

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