Probable amniotic fluid embolism after first-trimester pregnancy termination. A case report

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Reproductive Health

Background:

• Pregnancy termination via dilatation and curettage is a common procedure.
• Disseminated intravascular coagulation (DIC) is a life-threatening condition characterized by widespread clotting and bleeding.
• Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric emergency.

Observation:

• A patient experienced sudden collapse immediately following a dilatation and curettage procedure for pregnancy termination.
• Rapidly progressive disseminated intravascular coagulation (DIC) was observed in the patient post-procedure.
• The clinical presentation strongly suggested amniotic fluid embolism (AFE) as the underlying cause, despite the diagnosis remaining unproven.

Findings:

• The patient's collapse and subsequent DIC were most likely caused by amniotic fluid embolism (AFE).
• This case highlights the potential for AFE to occur even after seemingly routine procedures like dilatation and curettage.
• The rapid onset of DIC underscores the critical and unpredictable nature of AFE.

Implications:

• Prophylactic measures such as artificial rupture of membranes before dilatation and curettage may reduce the risk of AFE.
• Administration of oxytocic agents prior to or during the procedure could potentially mitigate AFE development.
• Increased awareness and consideration of AFE in patients presenting with sudden collapse and coagulopathy post-abortion are crucial for timely diagnosis and management.