Amniotic Fluid Embolism

The classic presentation of amniotic fluid embolism is the development of dyspnea and hypotension in association with labor or an abortion. Milder forms can present with sudden onset of shortness of breath and air hunger along with a decreased oxygen saturation that resolves spontaneously. Amniotic fluid embolism can be difficult to distinguish from pulmonary embolism. Patients can develop cardiac arrest within minutes, and if they survive they will go on to develop disseminated intravascular coagulation. Treatment is primarily supportive care along with invasive cardiac monitoring and correction of the coagulopathy. The use of cardiopulmonary bypass and open pulmonary artery thromboembolectomy has been used with success in a moribund patient with AFE.18

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