A total of 24 MU of oxytocin was given from 13:30 to 18:15. An intravenous infusion of lactated Ringer's solution was started, and the patient received prophylactic penicillin. At 10:15 the patient's hemoglobin was 11.6 g/dL. Fetal heart rate was normal at 120-130/minute. The patient's temperature was 36.3 o C, pulse 86/minute, blood pressure 135/85 mm Hg and respirations 20/minute. Her outpatient medications included only salmeterol/fluticasone inhaler for asthma, and prenatal vitamins. She was having irregular mild contractions. This 35-year-old mother of two was admitted to an urban hospital in the Midwest USA at 37 4/7 weeks gestation at 09:21 with spontaneous rupture of membranes since 04:00.
AMNIOTIC FLUID EMBOLISM TREATMENT SERIES
This series of three cases is reported in detail to highlight the variability in presentation and provide a didactic review to encourage rapid recognition and intervention. Emerging life-saving treatments for amniotic fluid embolism make it more promising to successfully treat this life-threatening cause of cardiovascular collapse during labor and delivery.
1 Among these complications, amniotic fluid embolism remains one of the most feared because of its suddenness, severity and frequently fatal outcome. Sudden cardiovascular collapse during labor and delivery can be due to pulmonary thromboembolism, hemorrhage, venous air embolism, anaphylaxis, high cephalad spread of epidural anesthesia, peripartum cardiomyopathy, eclampsia or amniotic fluid embolism. The obstetrician must always be on high alert for the rare emergency. Labor and delivery have the potential to become a critical experience for mother and baby.
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