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ID 114830
Title Alternative
Anesthetic Care of a Patient with AFE
Author
Hari, Yuki Tokushima University
Honda, Yasuhito Tokushima University
Keywords
amniotic fluid embolism
cardiopulmonary collapse type
cesarean section
disseminated intravascular coagulation
Content Type
Journal Article
Description
Two types of amniotic fluid embolism (AFE) have been described : cardiopulmonary collapse type and disseminated intravascular coagulation (DIC) type, with the latter proposed as uterine type. This report describes a healthy 28-year-old woman who developed AFE during a cesarean section. Because of a previous cesarean section, the patient underwent an elective cesarean section, under combined spinal-epidural anesthesia, at 38 weeks of pregnancy. She began coughing 5 minutes after delivery of the fetus, subsequently becoming unconscious and developing glossoptosis and bradycardia. Her blood pressure decreased to 76/43 mmHg, and AFE was suspected. Her uterus was atonic, and she experienced persistent noncoagulant bleeding, with a final blood loss of 6300 ml. Considerable blood transfusion was required. The patient survived, and she and her baby were discharged without any sequelae on the eighth postoperative day. This patient met the Japanese criteria for clinical AFE, with an obstetrical DIC score of 21 meeting the criteria for obstetrical DIC. Early diagnosis and treatment likely resulted in patient survival.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA12022913
AA11166929
Publisher
Tokushima University Faculty of Medicine
Volume
67
Issue
1-2
Start Page
207
End Page
210
Sort Key
207
Published Date
2020-02
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
University Hospital
Medical Sciences