Amniotic fluid embolism: a case report with a favorable outcome

Introduction . Amniotic fluid embolism (AFE) is a rare but life-threatening complication of childbirth, characterized by the sudden development of arterial hypotension, hypoxia, shock and coagulopathic disorders. AFE is one of the most formidable and unpredictable complications of childbirth, accompanied by high mortality. Despite its rarity (1:8,000–1:80,000 births), AFE remains the leading cause of maternal mortality. Pathogenesis is associated with the entry of amniotic fluid into the maternal bloodstream, which leads to cardiopulmonary shock, DIC syndrome and multiple organ failure. Diagnosis of AFE is difficult due to its lightning-fast development and the lack of specific markers. Treatment requires immediate multidisciplinary intervention, including resuscitation, surgical hemostasis and correction of coagulopathy. This article presents a case of a 34-year-old patient with risk factors (polyhydramnios, uterine scar, previous operative deliveries), who developed a clinical picture of EAF with multiple circulatory arrests, massive blood loss and multiple organ failure after an emergency cesarean section. The measures taken included cardiopulmonary resuscitation (CPR), surgery (ligation of uterine vessels, extirpation of the uterus, relaparotomy) and supportive therapy (plasmapheresis in the plasma exchange mode, ultrahemodiafiltration). Thanks to a timely multidisciplinary approach, a favorable outcome without neurological deficit was achieved. Conclusion . This case demonstrates that with early diagnosis, surgical and complex treatment with dynamic laboratory monitoring, it is possible to achieve a favorable outcome even in severe EAF.