A Case of Severe Acute Respiratory Distress Syndrome Secondary to Atypical Amniotic Fluid Embolism

Abstract

Acute respiratory distress syndrome (ARDS) is a noncardiogenic pulmonary edema that leads to acute respiratory distress. It remains one of the major diagnoses requiring ICU admission and mechanical ventilation. We present a case of a 25-year-old gravida 3 para 2 female who was admitted for uncomplicated 38-week pregnancy and delivered a healthy male infant but developed acute onset dyspnea six hours after vaginal delivery. She required mechanical ventilation four hours after the onset of respiratory distress and had to be transferred to a higher level facility for extracorporeal membrane oxygenation (ECMO) within 24 hours of the symptom onset. She was diagnosed with severe ARDS. Even though she missed the other typical feature of amniotic fluid embolism, atypical amniotic fluid embolism remained the most likely explanation for her symptoms after the other causes of ARDS were excluded.

Keywords: acute onset severe hypoxic respiratory failure; acute respiratory distress syndrome [ards]; afe (amniotic fluid embolism); atypical amniotic fluid embolism; pregnancy complication.

Figure 1. Dense bilateral pulmonary infiltrates on CT scan chest indicating ARDS (as indicated by the arrow)

ARDS: Acute respiratory distress syndrome.