[Amniotic fluid embolism with coagulation disorder--a case report (author's transl)]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Critical Care Medicine

Background:

• Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric emergency.
• Twin pregnancies present unique challenges in managing obstetric emergencies.
• Hyperfibrinolysis and disseminated intravascular coagulation are common complications of AFE.

Observation:

• A case of amniotic fluid embolism occurred during a twin pregnancy delivery.
• Immediate resuscitation included artificial ventilation, leading to survival of mother and neonates.
• Severe postpartum hemorrhage resulted from placental separation due to hyperfibrinolysis.

Findings:

• Fritsch's manoeuvre effectively controlled the dramatic postpartum hemorrhage.
• Coagulation disorder was successfully managed with fresh whole blood, fibrinogen, and Aprotinin (an antifibrinolytic agent).
• The combined interventions led to the stabilization of the patient.

Implications:

• This case highlights the importance of prompt and multidisciplinary management in AFE during twin pregnancies.
• Successful management strategies can improve maternal and neonatal outcomes in this high-risk scenario.
• Early recognition and treatment of hyperfibrinolysis and coagulopathy are crucial for survival.