Amniotic Fluid Embolism Complicated with Hepatic Rupture: A Case Report

Amniotic fluid embolism (AFE) is a rare but highly fatal complication during delivery. It occurs when amniotic fluid suddenly enters the maternal circulation, causing acute multi-organ failure. Prompt recognition and management are crucial for improving survival rates.

We reported a 37-year-old woman at 39 weeks gestation who developed AFE during labor induction. The patient presented with sudden cyanosis, dyspnea, and restlessness, followed by cardiac arrest during emergency cesarean section. Postoperative refractory postpartum hemorrhage (RPPH) necessitated multiple interventions, including hysterectomy and vascular embolization. Subsequent laparotomy revealed a subcapsular hematoma with linear tear in the left hepatic lobe, which was successfully repaired. The patient required massive transfusion and intensive care but eventually stabilized.

This case involved a life-threatening AFE complicated by cardiac arrest, RPPH, and traumatic liver rupture. The patient was successfully treated through multidisciplinary collaboration. It highlights three key aspects of critical maternal care: rapid recognition, damage control, and systemic resuscitation.