Amniotic fluid embolism (AFE) is a disorder with a high mortarity rate, because it often causes sudden
respiratory failure,
circulatory collapse and
disseminated intravascular coagulation (
DIC). We present a case of AFE in which an obstetric anesthesiologist promptly initiated
resuscitation of a parturient and saved her without any sequelae. Her fetus was diagnosed as intrauterine
fetal demise on 25th gestational week and vaginal delivery under
epidural analgesia was planned. One hundred and five minutes after
induction of labor with prostaglandine E1, sudden tetanic convulsion occurred with a
loss of consciousness. An obstetric anesthesiologist immediately started to resuscitate her and her consciousness was restored. However, noncoagulable
vaginal bleeding followed. As the
hemorrhage persisted, AFE was suspected. Anesthesiologists gave effective massive transfusion
therapy, and she recovered from coagulopathy. Total blood loss was 5,524 g. This case was diagnosed as AFE with high serum
sialyl-Tn antigen and
zinc-coproporphyrin. The obstetric anesthesiologists are one of the best groups of physicans for
resuscitation because they have skills in managing obstetric emergencies such as AFE. In this case, the crucial points for successful
resuscitation were prompt obstetric anesthesiologist involvement and good communications with obstetricians and midwives.