An amniotic fluid embolism (AFE) is one of the rare obstetric emergency with a high maternal mortality rate. This condition is clinically characterized by three distinct phases: during the first phase, sudden onset of respiratory distress and cyanosis occur within seconds followed by hypotension, shock, and loss of consciousness within minutes. Of those who survive the initial insult, 40 to 50% enter the second phase characterized by coagulopathy and hemorrhage within hours. During the third phase, acute symptoms are over, and tissue injury of the brain, lung or renal is for the most part already established. The patient may succumb due to multisystem organ failure or infection acquired in the hospital.We report an interesting case of a middle-aged pregnant mother who developed AFE during the caesarean section and complicated with severe postpartum hemorrhage, which was successfully aborted by intramyometrial prostaglandin F2 alpha injection, thus obviating the need for hysterectomy. Following that she also suffered from expressive dysphasia and have an uneventful recovery through the speech therapy. We concluded that early diagnosis and timely intervention that may be the best way to achieve the favorable outcome of amniotic fluid embolism and intramyometrial prostaglandin is the available simple drug for preventing a peripartum hysterectomy during amniotic fluid embolism.
The role of mobile technology has become an integral part of daily activity among today’s society, including medical schools and hospitals. This study aimed to establish a mobile-learning platform for providing high-quality clinical teaching in undergraduate medical education. It was a mixed-methods design of quantitative survey and qualitative focus-group discussions to analyse the learners' view for acceptance of technology-integrated learning in clinical teaching at Universiti Sultan Zainal Abidin. Forty-two undergraduate medical students from years 3 and 5 participated in this study. The vast majority found that a mobile-learning platform was a helpful medium for the integration of leaning resources and collaboration with other health-care professionals in a clinical setting (p<0.001). They generally agreed that there is an improvement in clinical competence, confidence in clinical reasoning and focusing on the discussion by providing constructive feedback (p<0.001). The qualitative focused group discussion’s findings indicated that most of the participants expressed their satisfaction with improving their intellectual skills and their anticipation of achieving strategic learning via integrated bedside teaching with mobile-group discussions. Overall, the participants accepted that a mobile-learning platform integrated bedside teaching is a constructive, productive approach for enhancing and facilitating their learning in a clinical setting. This study offered a unique insight into learners’ perceptions of benefits and the limitation of technology-enhanced learning in undergraduate medical training. The essential attributes of mobile technology are crucial for technology integration in high-quality clinical teaching.
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