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Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy

Amniotic fluid embolism (AFE) is a rare but life-threatening maternal emergency caused by the entry of amniotic fluid contents into the maternal circulation. The clinical manifestations of AFE are heterogeneous, leading to misdiagnosis or treatment delay. Kanayama and colleagues distinguished the ca...

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Autores principales: Yufune, Shinya, Tanaka, Motoshi, Akai, Ryosuke, Satoh, Yasushi, Furuya, Kenichi, Terui, Katsuo, Kanayama, Naohiro, Kazama, Tomiei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818681/
https://www.ncbi.nlm.nih.gov/pubmed/29497633
http://dx.doi.org/10.1186/s40981-015-0001-x
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author Yufune, Shinya
Tanaka, Motoshi
Akai, Ryosuke
Satoh, Yasushi
Furuya, Kenichi
Terui, Katsuo
Kanayama, Naohiro
Kazama, Tomiei
author_facet Yufune, Shinya
Tanaka, Motoshi
Akai, Ryosuke
Satoh, Yasushi
Furuya, Kenichi
Terui, Katsuo
Kanayama, Naohiro
Kazama, Tomiei
author_sort Yufune, Shinya
collection PubMed
description Amniotic fluid embolism (AFE) is a rare but life-threatening maternal emergency caused by the entry of amniotic fluid contents into the maternal circulation. The clinical manifestations of AFE are heterogeneous, leading to misdiagnosis or treatment delay. Kanayama and colleagues distinguished the cardiopulmonary collapse type (or classic type) from the disseminated intravascular coagulation (DIC) type of AFE on the basis of the presence of uterine atony and DIC in the latter prior to cardiopulmonary failure. We report a case of DIC-type AFE successfully treated by blood volume replacement and coagulation therapy. The patient was scheduled for elective cesarean delivery because of a previous cesarean section and moyamoya disease. Delivery was uneventful, but massive vaginal bleeding without clotting and ensuing hypovolemic shock occurred 4 h later. She was transferred to the operating room for emergency laparotomy, but sustained a cardiac arrest. The patient was successfully resuscitated and a hysterectomy performed. During surgery, the patient received fresh frozen plasma, platelets, fibrinogen, and antithrombin concentrate. In cardiopulmonary collapse type AFE, cardiopulmonary resuscitation without delay is important. In the present case of DIC-type AFE, however, early supplementation of clotting factors and platelets was critical for patient survival.
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spelling pubmed-58186812018-02-27 Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy Yufune, Shinya Tanaka, Motoshi Akai, Ryosuke Satoh, Yasushi Furuya, Kenichi Terui, Katsuo Kanayama, Naohiro Kazama, Tomiei JA Clin Rep Case Report Amniotic fluid embolism (AFE) is a rare but life-threatening maternal emergency caused by the entry of amniotic fluid contents into the maternal circulation. The clinical manifestations of AFE are heterogeneous, leading to misdiagnosis or treatment delay. Kanayama and colleagues distinguished the cardiopulmonary collapse type (or classic type) from the disseminated intravascular coagulation (DIC) type of AFE on the basis of the presence of uterine atony and DIC in the latter prior to cardiopulmonary failure. We report a case of DIC-type AFE successfully treated by blood volume replacement and coagulation therapy. The patient was scheduled for elective cesarean delivery because of a previous cesarean section and moyamoya disease. Delivery was uneventful, but massive vaginal bleeding without clotting and ensuing hypovolemic shock occurred 4 h later. She was transferred to the operating room for emergency laparotomy, but sustained a cardiac arrest. The patient was successfully resuscitated and a hysterectomy performed. During surgery, the patient received fresh frozen plasma, platelets, fibrinogen, and antithrombin concentrate. In cardiopulmonary collapse type AFE, cardiopulmonary resuscitation without delay is important. In the present case of DIC-type AFE, however, early supplementation of clotting factors and platelets was critical for patient survival. Springer Berlin Heidelberg 2015-08-27 2015 /pmc/articles/PMC5818681/ /pubmed/29497633 http://dx.doi.org/10.1186/s40981-015-0001-x Text en © The Author(s) 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Case Report
Yufune, Shinya
Tanaka, Motoshi
Akai, Ryosuke
Satoh, Yasushi
Furuya, Kenichi
Terui, Katsuo
Kanayama, Naohiro
Kazama, Tomiei
Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
title Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
title_full Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
title_fullStr Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
title_full_unstemmed Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
title_short Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
title_sort successful resuscitation of amniotic fluid embolism applying a new classification and management strategy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818681/
https://www.ncbi.nlm.nih.gov/pubmed/29497633
http://dx.doi.org/10.1186/s40981-015-0001-x
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