Division of Obstetric Anesthesia, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, Sagamihara, Japan.
Department of Anesthesiology, Kitasato University, School of Medicine, Sagamihara, Japan.
J Obstet Gynaecol Res. 2021 Sep;47(9):3374-3378. doi: 10.1111/jog.14880. Epub 2021 Jun 15.
Amniotic fluid embolism (AFE) is a rare but fatal obstetric complication, characterized by sudden cardiovascular collapse, respiratory failure, and disseminated intravascular coagulation. Maternal mortality associated with AFE is high, making early recognition and prompt treatment important. In AFE with cardiac arrest, survival following acute cardiopulmonary dysfunction is crucial. In recent years, venoarterial extracorporeal membrane oxygenation (VA-ECMO) has attracted attention as an aggressive treatment for AFE with cardiac arrest. A 40-year-old woman experienced sudden cardiac arrest due to AFE during cesarean section. Cardiopulmonary resuscitation and VA-ECMO (also called percutaneous cardiopulmonary support) were initiated early. Finally, she recovered without any complications. VA-ECMO can provide temporary respiratory and hemodynamic support until cardiopulmonary function improves after a few days in intensive care. VA-ECMO should be considered as an early treatment for AFE with cardiac arrest.
羊水栓塞(AFE)是一种罕见但致命的产科并发症,其特征为突然的心血管崩溃、呼吸衰竭和弥散性血管内凝血。与 AFE 相关的产妇死亡率很高,因此早期识别和及时治疗非常重要。在伴有心脏骤停的 AFE 中,急性心肺功能障碍后的生存至关重要。近年来,静脉-动脉体外膜肺氧合(VA-ECMO)作为一种治疗伴有心脏骤停的 AFE 的积极方法引起了关注。一名 40 岁的女性在剖宫产术中因 AFE 突然发生心脏骤停。心肺复苏和 VA-ECMO(也称为经皮心肺支持)早期启动。最终,她在没有任何并发症的情况下康复。VA-ECMO 可以在几天的重症监护后提供临时呼吸和血流动力学支持,直到心肺功能改善。VA-ECMO 应被视为伴有心脏骤停的 AFE 的早期治疗方法。