Successful emergency treatment of pregnant woman with amniotic fluid embolism

Pregnant woman Nguyen TL, 35 years old, was hospitalized to give birth for the fourth time, an IVF pregnancy of 36 weeks and 4 days with a history of 3 cesarean sections. Predicting that this was a case with many potential risks, the doctors and technicians of the Anesthesia and Resuscitation Department volunteered to prepare.

Before the cesarean section, the mother's health and vital signs were completely normal. However, when Master, Specialist II Doctor Tran Ngoc Dinh - Head of Department D5 had just performed the cesarean section to deliver the baby boy, the mother suddenly had a cardiac arrest, convulsions, and lost consciousness.

Immediately, the team of anesthesiologists including Associate Professor, Doctor Nguyen Duc Lam; Doctor, Doctor Tran Van Cuong and Master, Specialist II Luong Thi Ngoc Van focused on chest compressions, emergency intubation, mechanical ventilation, immediate invasive arterial blood pressure, central venous blood pressure with a 3-lumen catheter, and consulted with the Board of Directors to handle the obstetrics.

At the same time, the team also took blood for testing, took central venous blood to look for amniotic cells, and did a blood clotting test, which showed that the patient had a very severe blood clotting disorder even though the patient had not lost much blood.

Doctor, Specialist II Mai Trong Hung, Director of the Hospital, immediately appeared in the operating room to directly direct the operation.

After 5 minutes of CPR, the mother's heart started beating again. The hospital invited Professor, Doctor Nguyen Quoc Kinh - Vice President of the Vietnam Association of Anesthesia and Resuscitation, former Director of the Center for Anesthesia and Surgical Resuscitation, Viet Duc Friendship Hospital for consultation.

Professor Kinh went directly to Hanoi Obstetrics Hospital to direct the examination and consultation of the patient. The professor suggested an echocardiogram right on the operating table to give treatment instructions and thought about the direction that the patient had amniotic fluid embolism.

After the patient had a partial hysterectomy to stop the bleeding, along with the active resuscitation efforts of the doctors and medical staff of the hospital, at times having to use high doses of vasopressors and transfuse 6.4 liters of blood and blood products, the patient's parameters gradually returned to stability.

According to Associate Professor, Dr. Nguyen Duc Lam - Head of the Department of Voluntary Anesthesia and Resuscitation, after successful cardiopulmonary resuscitation, the mother's blood pressure was still very low, requiring high doses of vasopressors and postpartum hemorrhage due to blood clotting disorders.

After 3 hours of trying their best to save the patient, the patient was temporarily stable. Two hours after the surgery ended, the patient's pulse and blood pressure were stable, the hospital contacted to transfer the patient to the Emergency Department of Bach Mai Hospital. One day later, the patient was extubated and fully conscious, with stable pulse and blood pressure.

After 2 days, the patient was transferred to the Cardiovascular Hospital for further examination.

For 10 consecutive days, doctors at the Obstetrics Hospital successfully treated and saved the lives of two pregnant women suspected of having amniotic fluid embolism.

Source: https://nhandan.vn/cap-cuu-thanh-cong-san-phu-bi-thuyen-tac-mach-oi-post810470.html