Korean J Anesthesiol.
1997 Oct;33(4):778-783. 10.4097/kjae.1997.33.4.778.
Amniotic Fluid Embolism during Dilatation and Curettage in a Second Trimesteric Missed Aborted Pregnant Patient
- KMID: 2237743
- DOI: http://doi.org/10.4097/kjae.1997.33.4.778
Abstract
- Amniotic fluid embolism (AFE) is a rare but devasting obstetric emergency. We experienced a case of AFE during dilatation and curettage (D & C) in a 15 2/7 weeks pregnant woman, age 30, who was diagnosed as having a missed abortion. Sudden rapid hypoxemia, low SpO2, hypotension, low PETCO2, high CVP, and tachycardia, right axis deviation and right bundle branch block in 12 leads ECG were developed during D &C under general anesthesia, and signs of disseminated intravascular coagulation (DIC) followed after the operation, which are consistent with the findings of AFE. Even though there was no definite pathologic and radiologic confirmation of AFE, laboratory findings showed 100 times higher level of alpha-fetoprotein in her central venous blood than same weeks of missed abortion woman's blood. Though it is rare, the anesthesiologist should always suspect the possibility of AFE, when the patient shows an unexplained collapse, cyanosis, low PETCO2, high CVP, low SpO2, ECG change and DIC during any kind of obstetric procedure.
MeSH Terms
-
Abortion, Missed
alpha-Fetoproteins
Amniotic Fluid*
Anesthesia, General
Anoxia
Axis, Cervical Vertebra
Bundle-Branch Block
Cyanosis
Dacarbazine
Dilatation and Curettage*
Dilatation*
Disseminated Intravascular Coagulation
Electrocardiography
Embolism, Amniotic Fluid*
Emergencies
Female
Humans
Hypotension
Pregnancy
Pregnancy Trimester, Second*
Pregnant Women
Tachycardia
Dacarbazine
alpha-Fetoproteins
