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Amniotic Fluid Embolism
Tayyab Mohyuddin1, Shahbaz Sarwar1, Dawar Ayyaz2
1Department of Cardiology, National Hospital and Medical Center, Lahore.
Summary
A rare case of amniotic fluid embolism (AFE) occurred post-caesarean section, presenting with hypotension and DIC. Prompt supportive care led to full recovery without anticoagulation, highlighting AFE
Area of Science:
- Cardiology
- Obstetrics
- Critical Care Medicine
Background:
- Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric emergency.
- Post-caesarean section AFE presents diagnostic challenges, often mimicking other conditions.
Observation:
- A 34-year-old patient developed sudden hypotension, bradycardia, dyspnea, and disseminated intravascular coagulation (DIC) after an elective caesarean section.
- Echocardiography revealed significant right ventricular dysfunction, including McConell's sign and a positive 60/60 sign, indicative of acute right ventricular afterload.
- CT pulmonary angiogram was inconclusive for thromboembolism but showed indirect signs supporting AFE.
Findings:
- The patient received aggressive supportive care without anticoagulation.
- Complete clinical recovery was achieved.
- Follow-up echocardiogram after 9 days demonstrated normalization of right ventricular size and function, and improvement in the 60/60 sign.
Implications:
- This case underscores the importance of prompt recognition and aggressive supportive management in AFE.
- It suggests that anticoagulation may not be necessary in all AFE cases, particularly when DIC is a prominent feature.
- The rapid echocardiographic improvement highlights the reversibility of AFE-induced cardiac dysfunction with appropriate care.
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