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Extracorporeal Therapies for Amniotic Fluid Embolism
Julien Viau-Lapointe1, Niall Filewod
1Département de Médecine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, the Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
Obstetrics and Gynecology
|October 11, 2019
Summary
Amniotic fluid embolism (AFE) is a severe condition. Extracorporeal therapies, like ECMO, can support patients with AFE, even during bleeding complications.
Area of Science:
- Cardiology
- Obstetrics
- Critical Care Medicine
Background:
- Amniotic fluid embolism (AFE) is a rare but devastating obstetric emergency with high mortality.
- The cardiopulmonary dysfunction in AFE is often transient, suggesting potential benefit from supportive therapies.
Observation:
- A patient experiencing cardiac arrest post-cesarean delivery was diagnosed with AFE.
- Peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated due to severe hypoxemia and hypotension.
- The patient developed intra-abdominal bleeding requiring massive transfusion and surgical intervention.
Findings:
- Despite complications, the patient and newborn recovered well.
- A review of 19 similar cases indicates favorable outcomes with extracorporeal support.
- Extracorporeal therapies demonstrated efficacy in managing AFE-related cardiopulmonary failure.
Implications:
- Extracorporeal therapies, including ECMO, are viable options for supporting critically ill AFE patients.
- These therapies may be considered even in cases with disseminated intravascular coagulation and active bleeding.
- Successful application of ECMO in AFE highlights its role in managing severe obstetric emergencies.
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