Pulmonary amniotic fluid embolism; report of a fatal case.
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After a normal pregnancy and labour in a 29-year-old parturient, a single seizure followed by a transient headache was observed during the uterine revision for placental retention. Mild uterine haemorrhage of 150 ml per hour without any uterine atony was associated with activation of clotting and fibrinolysis (decrease of fibrinogen, elevated fibrin soluble complexes and D-dimers). A ten fold value of foetal blood cells in maternal serum suggested the diagnosis of amniotic fluid embolism. Atypical forms of amniotic fluid embolism and their diagnosis are discussed.
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We report the successful treatment of a moribund patient as a result of amniotic fluid embolism with cardiopulmonary bypass and open pulmonary artery thromboembolectomy. Review of the literature indicates that this is the first reported case of treatment of amniotic fluid embolism with cardiopulmonary bypass and pulmonary thromboembolectomy.
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A case is presented of non-fatal amniotic fluid embolism (AFE) with a severe shock complicated by acute respiratory distress syndrome (ARDS) with permanent pulmonary damage. Analysis of haemodynamic data of this patient suggests that diminished myocardial contractility and a decrease in peripheral vascular tone are the main causes of prolonged shock in AFE.
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