Use of Extracorporeal Membrane Oxygenation in a Fulminant Course of Amniotic Fluid Embolism Syndrome Immediately after Cesarean Delivery.
10.4266/kjccm.2016.00213
- Author:
Jae Ha LEE
;
Hang Jea JANG
;
Jin Han PARK
;
Yong Kyun KIM
;
Ho Ki MIN
;
Sun Young KIM
;
Hyun kuk KIM
- Publication Type:Case Report
- Keywords:
amniotic fluid embolism;
anaphylaxis;
extracorporeal membrane oxygenation
- MeSH:
Adult;
Amniotic Fluid*;
Anaphylaxis;
Anoxia;
Cardiopulmonary Bypass;
Cesarean Section;
Cognition;
Embolism, Amniotic Fluid*;
Extracorporeal Membrane Oxygenation*;
Female;
Humans;
Peripartum Period;
Pregnancy;
Pregnant Women;
Pulmonary Circulation;
Shock
- From:Korean Journal of Critical Care Medicine
2016;31(3):256-261
- CountryRepublic of Korea
- Language:English
-
Abstract:
Amniotic fluid embolism is rare but is one of the most catastrophic complications in the peripartum period. This syndrome is caused by a maternal anaphylactic reaction to the introduction of fetal material into the pulmonary circulation. When amniotic fluid embolism is suspected, the immediate application of extracorporeal mechanical circulatory support such as veno-arterial extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass should be considered. Without the application of extracorporeal mechanical circulatory support, medical supportive care might not be sufficient to maintain cardiopulmonary stabilization in severe cases of amniotic fluid embolism. In this report, we present the case of a 36-year-old pregnant woman who developed an amniotic fluid embolism immediately after a cesarean section. Her catastrophic event started with the sudden onset of severe hypoxia, followed by circulatory collapse within 8 minutes. The veno-arterial mode of extracorporeal membrane oxygenation was initiated immediately. She was successfully resuscitated but with impaired cognitive function. Thus, urgent ECMO should be considered when amniotic fluid embolism syndrome is suspected in patients presenting acute cardiopulmonary collapse.
