Related Experiment Video
Updated: Aug 9, 2026
04:08
Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
Published on: June 27, 2025
Placenta previa and accreta complicated by amniotic fluid embolism
Amedee C Mathelier1, Kirkor Karachorlu
1Department of Obstetrics and Gynecology and of Pathology St. Bernard Hospital Chicago, Illinois, USA.
International Journal of Fertility and Women'S Medicine
|April 7, 2006
Summary
This case highlights a rare obstetric event where placenta previa and accreta occurred after prior cesarean delivery, complicated by premature rupture of membranes and amniotic fluid embolism (AFE). Prompt recognition and management of AFE are crucial for patient survival.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Critical Care Obstetrics
Background:
- Previous low transverse cesarean delivery is a known risk factor for placenta previa and placenta accreta.
- The combination of these conditions with premature rupture of membranes and amniotic fluid embolism (AFE) represents a rare obstetric complication.
Observation:
- A 24-year-old woman with two prior cesarean deliveries presented at 32 weeks gestation with premature rupture of membranes.
- She underwent a repeat cesarean delivery, which was complicated by excessive hemorrhage and the development of amniotic fluid embolism.
Findings:
- The patient required a hysterectomy due to severe hemorrhage associated with placenta previa and accreta.
- The amniotic fluid embolism led to significant maternal morbidity, underscoring the unpredictable and severe nature of this obstetric emergency.
Implications:
- This case underscores the importance of vigilance for AFE in patients with a history of cesarean delivery, placenta previa, and accreta.
- Prompt diagnosis and aggressive management of AFE are critical to mitigate life-threatening complications such as massive hemorrhage and disseminated intravascular coagulopathy.
- Obstetricians must be prepared for sudden, unexpected AFE events and initiate immediate, aggressive treatment protocols.
Related Concept Videos
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:07Teratogenicity
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
01:14Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
01:25Pleural Effusion I: Introduction
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...