Amniotic fluid embolism complicated with severe PPH & neurol
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An amniotic fluid embolism (AFE) is one of the rare obstetric emergency with a high maternal mortality rate. This condition is clinically characterized by three distinct phases: during the first phase, sudden onset of respiratory distress and cyanosis occur within seconds followed by hypotension, shock, and loss of consciousness within minutes.

Of those who survive the initial insult, 40 to 50% enter the second phase characterized by coagulopathy and hemorrhage within hours. During the third phase, acute symptoms are over, and tissue injury of the brain, lung or renal is for the most part already established. The patient may succumb due to multisystem organ failure or infection acquired in the hospital.

Published in the Journal of South Asian Federation of Obstetrics and Gynaecology, the authors report an interesting case of a middle-aged pregnant mother who developed AFE during the caesarean section and complicated with severe postpartum hemorrhage, which was successfully aborted by intramyometrial prostaglandin F2 alpha injection, thus obviating the need for hysterectomy.

Following that she also suffered from expressive dysphasia and have an uneventful recovery through speech therapy.

Learning Points:-
- Early diagnosis and timely intervention may be the best way to achieve the favorable outcome of amniotic fluid embolism

- Intramyometrial prostaglandin is the available simple drug for preventing a peripartum hysterectomy during amniotic fluid embolism

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