Embolic Stroke Following an Amniotic Fluid Embolism in the Setting of Patent Foramen Ovale

Amniotic fluid embolism (AFE) is a rare but devastating complication during pregnancy. We present an instance of an embolic stroke following an AFE in labor with a concurrent patent foramen ovale (PFO). The patient was a 34-year-old G4P2 who had an acute seizure event intrapartum. She was taken for an emergent cesarean delivery during which she was noted to have cardiopulmonary compromise. A cesarean hysterectomy was performed due to ongoing DIC and hemorrhage. Postoperatively, she was found to have evidence of thrombotic emboli as well as a PFO. She had a good neurologic recovery with supportive measures even prior to discharge from the hospital and has continued to do well. When more common etiologies of intrapartum seizures have been excluded, providers should maintain a high index of suspicion for embolic stroke.