Dilemma Diagnosis Between Pulmonary Embolism and Amniotic Fluid Embolism During First Stage of Labor—A Case Report

We report the sudden onset of dyspnea and loss of consciousness and fetal bradycardia in a middle-aged obese nulliparous woman at 39 weeks of gestation during first stage of labor leading to the decision for emergency cesarean section. Still during surgery, the mother underwent cardiac arrest. Transesophageal echocardiography during resuscitation showed right ventricular failure leading to the diagnosis of pulmonary embolism. Return of spontaneous circulation was achieved after emergency administration of thrombolysis with alteplase and cardiopulmonary resuscitation after 40 min. Severe bleeding, coagulopathy and persistent right ventricular failure resulted in persistent hemodynamic instability leading to supracervical hysterectomy and veno-arterial extracorporal life support. Both mother and baby survived without hypoxic brain injury.

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Publication Details

Journal
Clinical Case Reports
Published
2024-11-01
DOI
https://doi.org/10.1002/ccr3.9579
Citations
2
Primary Topic
Maternal and fetal healthcare
Type
article
Field-Weighted Citation Impact
2.22
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article

Dilemma Diagnosis Between Pulmonary Embolism and Amniotic Fluid Embolism During First Stage of Labor—A Case Report

Thilo Hackert, Kristina Killinger, Dittmar Böckler, Markus Wallwiener et al.
2 citations
Clinical Case Reports
Maternal and fetal healthcare
2.22
article

Dilemma Diagnosis Between Pulmonary Embolism and Amniotic Fluid Embolism During First Stage of Labor—A Case Report

Thilo Hackert, Kristina Killinger, Dittmar Böckler, Markus Wallwiener, Philipp Erhart, Philippe Grieshaber, Mascha O. Fiedler, Anna Sophie Scholz, Stephanie Wallwiener, Fabian Riedel, Thomas Müller, Markus A. Weigand, Michael Elsässer, Günter Germann
article en
2 citations

Abstract

We report the sudden onset of dyspnea and loss of consciousness and fetal bradycardia in a middle-aged obese nulliparous woman at 39 weeks of gestation during first stage of labor leading to the decision for emergency cesarean section. Still during surgery, the mother underwent cardiac arrest. Transesophageal echocardiography during resuscitation showed right ventricular failure leading to the diagnosis of pulmonary embolism. Return of spontaneous circulation was achieved after emergency administration of thrombolysis with alteplase and cardiopulmonary resuscitation after 40 min. Severe bleeding, coagulopathy and persistent right ventricular failure resulted in persistent hemodynamic instability leading to supracervical hysterectomy and veno-arterial extracorporal life support. Both mother and baby survived without hypoxic brain injury.

Clinical Case ReportsVol. 12(11)
Universität Hamburg (DE), Heidelberg University (DE), University Hospital Heidelberg (DE), University Hospital in Halle (DE)
Openalex Percentile: Top 11%
Maternal and fetal healthcare
2.22
DOIOpen Access PDFOpenAlex
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Dilemma Diagnosis Between Pulmonary Embolism and Amniotic Fluid Embolism During First Stage of Labor—A Case Report — Thilo Hackert, Kristina Killinger, et al. · Clinical Case Reports (2024) | TGRS Research Map | TGRS