Successful resuscitation by using extracorporeal membrane oxygenation in a patient with amniotic fluid embolism: a case report

J Int Med Res. 2020 Feb;48(2):300060520903640. doi: 10.1177/0300060520903640.

Abstract

Amniotic fluid embolism (AFE) is a rare disease, but it is a potentially fatal condition, as well as a leading cause of unpredictable maternal death in developed countries. The typical clinical symptoms of AFE include hypoxia, hypotension, and coagulopathy, and with rapid progression, it may cause cardiac arrest and death. We report a case of sudden hemodynamic instability due to amniotic fluid embolism, which was successfully treated with veno-arterial extracorporeal membrane oxygenation (ECMO). A 39-year-old woman was scheduled for delivery at 38 weeks and 2 days of gestation. During labor, sudden generalized tonic-clonic seizures developed, followed by dyspnea and cyanosis. Despite immediate cesarean section being performed, she became hypoxemic and experienced cardiovascular collapse. ECMO was promptly applied, and the patient became stable 8 days after cesarean section. ECMO appears to be an appropriate treatment option for catastrophic amniotic fluid embolism.

Keywords: Amniotic fluid embolism; cardiovascular collapse; cesarean section; disseminated intravascular coagulation; extracorporeal membrane oxygenation; hemodynamic instability.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section
  • Embolism, Amniotic Fluid / therapy*
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Humans
  • Obstetric Labor Complications / therapy*
  • Pregnancy
  • Resuscitation / methods*
  • Treatment Outcome