Erschienen in:
16.02.2016 | Case Reports / Case Series
Amniotic fluid embolism complicating medical termination of pregnancy
verfasst von:
Fatma Medhioub Kaaniche, MD, Anis Chaari, MD, Manel Zekri, MD, Mabrouk Bahloul, MD, Hedi Chelly, MD, Mounir Bouaziz, MD
Erschienen in:
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
|
Ausgabe 7/2016
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Abstract
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.