Disseminated intravascular coagulation type of amniotic fluid embolism: a challenging case report with favorable outcome

Abstract

Amniotic fluid embolism (AFE) is an unforeseeable, life-threatening complication of pregnancy and child birth. Although rare in an absolute sense, most contemporary series of maternal deaths from developed countries report AFE as a leading cause of mortality in the pregnant population. It has a heterogeneous presentation. This clinical heterogeneity makes the diagnosis of AFE difficult based on a beam of clinical and para-clinical arguments. Rapid diagnosis and immediate interdisciplinary treatment are essential for a good outcome. The present is a case of AFE with a disseminated intravascular coagulation (DIC) and a cardiorespiratory collapse following a vaginal delivery.

Amniotic fluid pulmonary embolism and COVID-19: Case report

“…AFE is an obstetric complication of unknown cause. It is caused by the entry of amniotic fluid and fetal components (meconium, mucus, sebum, lanugo, and amniotic cell debris) into the maternal circulation during labor, which causes exaggerated activation of the immune system [1 , 5] .…”

“…Atypical AFE is divided into cardiopulmonary AFE without DIC as in the case presented and, on the other hand, fibrinogen, coagulation times, platelets and liver function were normal. Finally, the other type, AFE with DIC without circulatory and respiratory alterations [1 – 5] .…”

“…AFE affects 1.7:100,000 mothers; mortality is estimated at 61%-86% of cases, with a fetal survival rate of 70% [4 , 5] . Diagnosis is by exclusion [5 , 6] and treatment is based on interdisciplinary work, ensuring the airway, guaranteeing adequate oxygenation, and circulatory support [4] , [5] , [6] – 7] .…”