Barakat Munsef, Alamami Ans, Ait Hssain Ali
Internal Medicine Residency Program, Medical Education, Hamad General Hospital, Doha, QAT.
Critical Care, Hamad General Hospital, Doha, QAT.
Cureus. 2022 Feb 21;14(2):e22475. doi: 10.7759/cureus.22475. eCollection 2022 Feb.
Amniotic fluid embolism (AFE) is a rare but devastating complication of pregnancy and is associated with high morbidity and mortality. Identifiable maternal risk factors for AFE include older age, multiparity, cesarean section, and placenta previa, while fetal factors include male gender, fetal distress, and death. AFE presents with respiratory distress, seizure, and circulatory collapse and can be complicated with disseminated intravascular coagulopathy, multiorgan failure, and death. In our case, we present a patient who underwent elective cesarean section for placenta previa, which was complicated by sudden cardiac arrest immediately after delivering the placenta in the operating theatre followed by disseminated intravascular coagulation (DIC). The patient developed massive post-partum hemorrhage secondary to the underlying DIC, which required a massive blood transfusion along with platelets, fresh frozen plasma (FFP), and tranexamic acid. The Society of Maternal-Fetal Medicine proposed criteria for the diagnosis of AFE, which include clinical features and laboratory findings. The presence of a DIC picture is considered to be the hallmark finding that helps to differentiate between AFE and other conditions with similar presentation. Treatment of amniotic fluid embolism depends on early recognition and supportive care.
羊水栓塞（AFE）是一种罕见但极具破坏性的妊娠并发症，与高发病率和死亡率相关。可识别的AFE产妇危险因素包括高龄、多产、剖宫产和前置胎盘，而胎儿因素包括男性胎儿、胎儿窘迫和死亡。AFE表现为呼吸窘迫、癫痫发作和循环衰竭，并可并发弥散性血管内凝血、多器官功能衰竭和死亡。在我们的病例中，我们介绍了一名因前置胎盘接受择期剖宫产的患者，该患者在手术室娩出胎盘后立即并发心搏骤停，随后发生弥散性血管内凝血（DIC）。患者因潜在的DIC继发大量产后出血，需要大量输血以及输注血小板、新鲜冰冻血浆（FFP）和氨甲环酸。母胎医学协会提出了AFE的诊断标准，包括临床特征和实验室检查结果。DIC表现被认为是有助于区分AFE与其他表现相似疾病的标志性发现。羊水栓塞的治疗取决于早期识别和支持治疗。
