A Case of Sudden Shock during Caesarean Section in whi ch Amniotic Fluid Embolism is Suspected

Masui. 2017 May;66(5):546-549.
[Article in English, Japanese]

Abstract

We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned. Hypotension followed and a small dose of adrenaline was infused for three days. She made good progress and was discharged without significant sequela. Cardiopulmonary collapse type of amniotic fluid embolism (AFE) is doubtful in this case. The necessity of rapid and appropriate treatment for emergency obstetric cases was discussed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anesthesia, Spinal / adverse effects*
  • Bradycardia
  • Cardiopulmonary Resuscitation
  • Cesarean Section*
  • Dyspnea
  • Embolism, Amniotic Fluid / chemically induced
  • Embolism, Amniotic Fluid / therapy*
  • Epinephrine / therapeutic use
  • Female
  • Humans
  • Intraoperative Complications
  • Parturition
  • Pregnancy
  • Shock / chemically induced*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents
  • Epinephrine