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Case Reports
. 2021 Sep;47(9):3374-3378.
doi: 10.1111/jog.14880. Epub 2021 Jun 15.

Venoarterial extracorporeal membrane oxygenation as an early treatment for amniotic fluid embolism with cardiac arrest: A case report

Mariko Adachi  1 , Takeshi Adachi  2 , Tomoe Fujita  1 , Shunsuke Hyuga  1 , Yoko Onishi  3 , Toshiyuki Okutomi  1
Affiliations
Case Reports

Venoarterial extracorporeal membrane oxygenation as an early treatment for amniotic fluid embolism with cardiac arrest: A case report

Mariko Adachi et al. J Obstet Gynaecol Res. 2021 Sep.

Abstract

Amniotic fluid embolism (AFE) is a rare but fatal obstetric complication, characterized by sudden cardiovascular collapse, respiratory failure, and disseminated intravascular coagulation. Maternal mortality associated with AFE is high, making early recognition and prompt treatment important. In AFE with cardiac arrest, survival following acute cardiopulmonary dysfunction is crucial. In recent years, venoarterial extracorporeal membrane oxygenation (VA-ECMO) has attracted attention as an aggressive treatment for AFE with cardiac arrest. A 40-year-old woman experienced sudden cardiac arrest due to AFE during cesarean section. Cardiopulmonary resuscitation and VA-ECMO (also called percutaneous cardiopulmonary support) were initiated early. Finally, she recovered without any complications. VA-ECMO can provide temporary respiratory and hemodynamic support until cardiopulmonary function improves after a few days in intensive care. VA-ECMO should be considered as an early treatment for AFE with cardiac arrest.

Keywords: amniotic fluid embolism; cardiac arrest; coagulopathy; venoarterial extracorporeal membrane oxygenation.

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