| CASE REPORT |
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| Year : 2022 | Volume
: 6
| Issue : 3 | Page : 191-195 |
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Amniotic fluid embolism with cardiac arrest and coagulopathy during Cesarean section: A case report
Lan Fern Michele Lim, Xiu Ling Jacqueline Sim, Ban Leong Sng
Department of Women’s Anaesthesia, KK Women’s and Children’s Hospital, Singapore
Correspondence Address:
Lan Fern Michele Lim
Department of Women’s Anaesthesia, KK Women’s and Children’s Hospital, 100 Bukit Timah Rd
Singapore
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/bjoa.bjoa_96_22
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Amniotic fluid embolism (AFE) is a rare but potentially fatal condition of pregnancy. It is a diagnosis of exclusion and its management largely supportive. We present a case of a 36-year-old patient who was admitted at 32 weeks gestational age with an acute abdomen. She underwent an emergency Cesarean section for fetal distress secondary to possible placental abruption. This was complicated by post-delivery cardiac arrest and respiratory failure from suspected AFE, disseminated intravascular coagulation and severe postpartum hemorrhage. She was managed with vasopressors, point-of-care coagulation testing, massive transfusion, anti-fibrinolytics, fibrinogen concentrate and eventual hysterectomy. Post-operatively, she was treated for acute respiratory distress syndrome in the intensive care unit. She and her neonate survived with good outcome. We discuss the practical constraints faced in the diagnosis and management of AFE, due to a lack of specific diagnostic tests and the need for prompt high-quality resuscitation, simultaneous management of coagulopathy and massive hemorrhage, timely activation of senior personnel and the involvement of a multi-disciplinary team in a crisis situation. |
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