Ms. Kuang, 28 years old, was hospitalized in Clifford Hospital after intrauterine pregnancy for 40 weeks and 1 day, bloody show and abdominal pain. On admission, vaginal delivery was recommended for her first. One day later, the uterine was fully dilated, but the heart rate of the baby slow down to 50 beats/min gradually according to the heart rate monitoring.

Physical examination: uterus was dilated to 10 centimeter; membrane was ruptured; amniotic fluid was clear; baby’s head was shown. She changed her position to side-lying position. Glucose and vitamin C were given to her by intravenous drip. However, the baby’s heart beat was not improved. Considering it may be acute fetal distress, doctor performed C-section on her. And then a baby girl was delivered, weighing 2.9 kg. After surgery, Ms. Kuang discharged incoagulable blood from her vagina, and abdominal wound gradually oozes blood with congestion of surrounding skin. One hour after the surgery, the amount of bleeding was about 960ml. Amniotic fluid embolism was not excluded. Dexamethasone was injected and blood transfusion was given immediately.

Through emergency treatment, the patient got better and was transferred to the

Third Affiliated Hospital of Guangzhou Medical University.                

Comments:

Amniotic fluid embolism is a rare but serious condition that occurs when amniotic fluid or fetal material enters the mother’s bloodstream, causing acute pulmonary embolism, allergic shock, disseminated intravascular coagulation (DIC), kidney failure, etc. Amniotic fluid embolism is most likely to occur during delivery or immediately afterward. The death rate of amniotic fluid embolism is up to 60%. In this case, treatment was given immediately to prevent potentially life-threatening complications.