Kim Jae Won, Kim Jin Hwan, Kim Tae Woo, Ryu Keon Hee, Park Sun Gyoo, Jeong Chang Young, Choi Jin Ho, Park Dong Ho
Department of Anesthesiology and Pain Medicine, Eulji University Medical Center, Daejeon, Korea.
Department of Thoracic and Cardiovascular Surgery, Eulji University Medical Center, Daejeon, Korea.
J Int Med Res. 2020 Feb;48(2):300060520903640. doi: 10.1177/0300060520903640.
Amniotic fluid embolism (AFE) is a rare disease, but it is a potentially fatal condition, as well as a leading cause of unpredictable maternal death in developed countries. The typical clinical symptoms of AFE include hypoxia, hypotension, and coagulopathy, and with rapid progression, it may cause cardiac arrest and death. We report a case of sudden hemodynamic instability due to amniotic fluid embolism, which was successfully treated with veno-arterial extracorporeal membrane oxygenation (ECMO). A 39-year-old woman was scheduled for delivery at 38 weeks and 2 days of gestation. During labor, sudden generalized tonic-clonic seizures developed, followed by dyspnea and cyanosis. Despite immediate cesarean section being performed, she became hypoxemic and experienced cardiovascular collapse. ECMO was promptly applied, and the patient became stable 8 days after cesarean section. ECMO appears to be an appropriate treatment option for catastrophic amniotic fluid embolism.
羊水栓塞（AFE）是一种罕见疾病，但它是一种潜在的致命病症，也是发达国家孕产妇不可预测死亡的主要原因。AFE的典型临床症状包括缺氧、低血压和凝血病，并且随着病情迅速进展，可能导致心脏骤停和死亡。我们报告一例因羊水栓塞导致的突发血流动力学不稳定病例，该病例通过静脉-动脉体外膜肺氧合（ECMO）成功治疗。一名39岁女性计划在妊娠38周零2天时分娩。分娩期间，突然出现全身强直性阵挛性癫痫发作，随后出现呼吸困难和发绀。尽管立即进行了剖宫产，但她仍出现低氧血症并经历了心血管崩溃。ECMO被迅速应用，患者在剖宫产后8天病情稳定。ECMO似乎是治疗灾难性羊水栓塞的一种合适治疗选择。
