SUCCESSFUL RESUSCITATION OF MATERNAL CARDIAC ARREST SECONDARY TO AMNIOTIC FLUID EMBOLISM AFTER CESAREAN DELIVERY: A CASE REPORT
Main Article Content
Abstract
Background: Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric complication that can rapidly lead to cardiovascular collapse, severe coagulopathy, and maternal cardiac arrest. Despite its low incidence, AFE remains one of the leading causes of maternal mortality worldwide. The diagnosis of AFE is primarily based on clinical presentation and is typically established after excluding other potential causes of cardiac arrest. Therefore, early recognition and prompt multidisciplinary management play a crucial role in improving patient outcomes.
Methods: We report a successfully resuscitated case of maternal cardiac arrest suspected to be caused by amniotic fluid embolism following cesarean delivery at the Department of Anesthesiology and Intensive Care, Hanoi Obstetrics and Gynecology Hospital.
Case presentation: A 31-year-old pregnant woman (PARA 2002) at 38 weeks and 6 days of gestation underwent cesarean section due to active labor with a history of a previous cesarean delivery. Combined spinal–epidural anesthesia was administered. The patient remained hemodynamically stable after spinal anesthesia. However, one minute after placental delivery, the patient suddenly developed cardiac arrest. Advanced cardiopulmonary resuscitation was immediately initiated according to current guidelines, and return of spontaneous circulation was achieved. Subsequently, the patient developed severe coagulopathy with disseminated intravascular coagulation, raising suspicion of amniotic fluid embolism. Intensive management was provided, including transfusion of blood products guided by rotational thromboelastometry (ROTEM), mechanical ventilation, sedation, and emergency subtotal hysterectomy. The patient's condition gradually improved; she was successfully extubated on postoperative day 3 and discharged on day 10 with full neurological recovery.
Conclusion: Early recognition of amniotic fluid embolism, together with prompt management and intensive multidisciplinary resuscitation, may significantly improve survival and reduce long-term complications in affected patients.
Keywords
Amniotic fluid embolism, cesarean section, maternal cardiac arrest
Article Details
References
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