Amniotic fluid embolism complicating medical termination of pregnancy

Background Amniotic fluid embolism is always a severe complication and generally occurs during labour or immediately after childbirth. Clinical features We report the case of a patient falling victim to amniotic fluid embolism after the medical termination of her pregnancy at 24 weeks of amenorrhea...

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Bibliographic Details
Published in:Canadian journal of anesthesia 2016-07, Vol.63 (7), p.871-874
Main Authors: Kaaniche, Fatma Medhioub, Chaari, Anis, Zekri, Manel, Bahloul, Mabrouk, Chelly, Hedi, Bouaziz, Mounir
Format: Article
Language:English
Subjects:
Abortion, Eugenic
Adult
Anesthesiology
Cardiology
Case Reports
Case Series
Critical Care Medicine
Embolism, Amniotic Fluid - diagnosis
Embolism, Amniotic Fluid - therapy
Female
Humans
Intensive
Medicine
Medicine & Public Health
Pain Medicine
Pediatrics
Pneumology/Respiratory System
Pregnancy
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Summary:Background Amniotic fluid embolism is always a severe complication and generally occurs during labour or immediately after childbirth. Clinical features We report the case of a patient falling victim to amniotic fluid embolism after the medical termination of her pregnancy at 24 weeks of amenorrhea following the discovery of a teratoma-carrying foetus. The amniotic fluid embolism diagnosis was strongly suspected in the face of the sudden onset of severe arterial hypotension, hypoxic respiratory distress, a coma state and disseminated intravascular coagulopathy immediately after the delivery. Additional tests were conducted to support the diagnosis: cytological testing of a peripheral venous sample and maternal broncho-alveolar lavage fluid, dosing of tryptase and alpha-fetoprotein levels as well as screening for insulin-like growth factor binding protein 1. Conclusion Amniotic fluid embolism is a rare and difficult diagnosis, especially in unconventional settings, yet it can be facilitated by screening for amniotic markers and tryptase.
ISSN:0832-610X
1496-8975
DOI:10.1007/s12630-016-0618-x