Amniotic fluid embolism is a rare syndrome with potentially lethal outcomes. Complications include cardiorespiratory failure, disseminated intra-vascular coagulation, seizures, neurological deficits, and death. A 34-year-old woman had amniotic fluid embolism complicated by paradoxical embolism and disseminated intravascular coagulation. Emergency cesarean section followed by cardiopulmonary bypass with removal of the clot from the atria and closure of the patent foramen ovale was performed, resulting in a good outcome for both the mother and the baby. Subsequent treatment with anticoagulants for 6 months was recommended. A literature review revealed that this clinical scenario is rare but can be successfully managed by cardiopulmonary bypass and thromboembolectomy. Data on guidelines for the use of anticoagulation in this situation are limited.
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1 July 2010
Cases of Note|
July 01 2010
Amniotic Fluid Embolism Complicated by Paradoxical Embolism and Disseminated Intravascular Coagulation
Sumeet Kumar, MD;
Sumeet Kumar, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Glenn Wong, MD;
Glenn Wong, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Michael Maysky, MD;
Michael Maysky, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Mark Shulman, MD;
Mark Shulman, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Stephen Olenchock, MD;
Stephen Olenchock, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Maria Falzon-Kirby, MD;
Maria Falzon-Kirby, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Thein H. Oo, MD
Thein H. Oo, MD
All authors are on staff at Caritas St Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Am J Crit Care (2010) 19 (4): 379–382.
Citation
Sumeet Kumar, Glenn Wong, Michael Maysky, Mark Shulman, Stephen Olenchock, Maria Falzon-Kirby, Thein H. Oo; Amniotic Fluid Embolism Complicated by Paradoxical Embolism and Disseminated Intravascular Coagulation. Am J Crit Care 1 July 2010; 19 (4): 379–382. doi: https://doi.org/10.4037/ajcc2009957
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