Abstract

Background: Amniotic fluid embolism (AFE) is a rare complication of pregnancy whose physiopathology is not completely known and still not frequently remembered by intensive care physicians and obstetricians. Being extremely serious with sudden onset
with hypotension or cardiorespiratory collapse, respiratory difficulty and coagulopathy. The objective of the case report is to describe a serious case that, with precise procedures, was discharged from hospital on the 13th day after 11 days in an ICU.
Case report: Female patient, 34 years old, pregnancy III, birth by cesarean II, at 39 weeks of gestational age, scheduled for elective cesarean section. Normal evolution during pregnancy. Following the delivery of her baby, the mother suffered a cardiocirculatory and respiratory collapse. Following a protracted treatment, transesophageal echocardiography
demonstrated evidence of acute pulmonary hypertension, with an empty left ventricle and an over-distended right ventricle. Six hours after the first symptoms with a new condition, she was taken to the ICU where she recovered after resuscitation maneuvers. On the 7th day of mechanical ventilation, the patient was extubated without complications. On the 10th
day of hospitalization, a new chest CT scan was performed showing the evolution of the pulmonary condition.
Conclusion: AFE is a rare but serious condition with high mortality and morbidity rates. Sudden cardiovascular collapse is induced by hypoxemia and hypotension Early detection, diagnosis, and treatment of AFE are essential to avoiding fatal result. The management of AFE involves a multidisciplinary team.

Keywords

Spinal anesthesia, Cesarean Section, Amniotic Fluid, Embolism, Pregnancy, Acute Respiratory Distress Syndrome, Electrical Impedance Tomography, Titration of Positive End-Expiratory Pressure