DEPARTMENT OF INTERNAL MEDICINE AND CARDIOLOGY, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND.
STUDENTS` SCIENTIFIC ASSOCIATION BY DEPARTMENT OF INTERNAL MEDICINE AND CARDIOLOGY, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND.
Wiad Lek. 2021;74(8):2011-2015.
Amniotic fluid embolism (AFE) is a diagnostically challenging type of pulmonary embolism that occurs when amniotic fluid enters maternal circulation during delivery or postpartum. This obstetric complication is very rare but characterized by high mortality rate. The main symptoms are dyspnea, cardiovascular collapse, disseminated intravascular coagulation (DIC) and even sudden cardiac death. The aim of the article is to draw attention to AFE as a rare but possible and catastrophic complication of perinatal period. The authors present a 28-year-old woman who was admitted to obstetric ward during the first stage of labour. The patient developed sudden deterioration of her medical state with acute respiratory distress symptoms. An emergency cesarean section was performed, complicated by excessive bleeding. After a detailed assessment of the patient's condition and evaluation of the results of additional tests, we diagnosed AFE as the cause of the patient's deterioration.
Conclusions: The case study shows how unpredictable, unpreventable and dangerous is AFE. It is still one of the main causes of maternal deaths in developed countries. Four diagnostic criteria proposed by the Society for Maternal-Fetal Medicine (SMFM) may accelerate diagnosis. AFE as a medical emergency, requires immediate multidisciplinary response and aggressive treatment. The initial medical care may be facilitated by the application of the general guidelines recommended by SMFM. The case report also emphasizes the need for further research on this disease, in particular on early detection and prevention.
羊水栓塞（AFE）是一种在分娩或产后期间羊水进入母体循环时发生的具有挑战性的肺栓塞类型。这种产科并发症非常罕见，但死亡率很高。主要症状是呼吸困难、心血管衰竭、弥散性血管内凝血（DIC）甚至心脏骤停。本文的目的是提请人们注意 AFE 作为围产期罕见但可能发生的灾难性并发症。作者介绍了一位 28 岁的女性，她在分娩第一阶段入住产科病房。该患者突发医疗状态恶化，出现急性呼吸窘迫症状。紧急行剖宫产术，并发大量出血。在详细评估患者病情和评估其他检查结果后，我们诊断 AFE 是导致患者病情恶化的原因。
该病例研究表明 AFE 是多么不可预测、不可预防和危险。它仍然是发达国家产妇死亡的主要原因之一。母体胎儿医学学会 (SMFM) 提出的四项诊断标准可能会加速诊断。作为一种医疗急救，AFE 需要立即进行多学科反应和积极治疗。SMFM 推荐的一般指南的应用可能会使初步医疗护理更加便利。该病例报告还强调了对这种疾病进行进一步研究的必要性，特别是在早期发现和预防方面。
