Chest computed tomography of a patient revealing severe hypoxia due to amniotic fluid embolism: a case report

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• 作者：Hideaki Imanaka (1)
  Bunji Takahara (1)
  Harutaka Yamaguchi (1)
  Emiko Nakataki (1)
  Akiko Mano (1)
  Daisuke Inui (1)
  Jun Oto (1)
  Masaji Nishimura (1)
  
• 刊名：Journal of Medical Case Reports
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：4
• 期：1
• 全文大小：719KB
• 参考文献：1. Clark SL, Hankins GDV, Dudley DA, Dildy GA, Porter TF: Amniotic fluid embolism: analysis of the national registry. / Am J Obstet Gynecol 1995, 172:1158鈥?169. CrossRef
  2. Kramer MS, Rouleau J, Baskett TF, Joseph KS: Maternal Health Study Group of the Canadian Perinatal Surveillance System. Amniotic fluid embolism and medical induction of labor: a retrospective, population-based cohort study. / Lancet 2006, 368:1444鈥?448. CrossRef
  3. Moore J, Baldisseri MR: Amniotic fluid embolism. / Crit Care Med 2005, 33:S279-S285. CrossRef
  
• 作者单位：Hideaki Imanaka (1)
  Bunji Takahara (1)
  Harutaka Yamaguchi (1)
  Emiko Nakataki (1)
  Akiko Mano (1)
  Daisuke Inui (1)
  Jun Oto (1)
  Masaji Nishimura (1)
  
  1. Department of Emergency and Critical Care, The University of Tokushima Graduate School, 770-8503, Kuramoto Tokushima, Japan
  

文摘

Introduction Amniotic fluid embolism is one of the most severe complications in the peripartum period. Because its onset is abrupt and fulminant, it is unlikely that there will be time to examine the condition using thoracic computed tomography (CT). We report a case of life-threatening amniotic fluid embolism, where chest CT in the acute phase was obtained. Case presentation A 22-year-old Asian Japanese primiparous woman was suspected of having an amniotic fluid embolism. After a Cesarean section for cephalopelvic disproportion, her respiratory condition deteriorated. Her chest CT images were examined. CT findings revealed diffuse homogeneous ground-glass shadow in her bilateral peripheral lung fields. She was therefore transferred to our hospital. On admission to our hospital's intensive care unit, she was found to have severe hypoxemia, with SpO2 of 50% with a reservoir mask of 15 L/min oxygen. She was intubated with the support of noninvasive positive pressure ventilation. She was successfully extubated on the sixth day, and discharged from the hospital on the twentieth day. Conclusion This is the first case report describing amniotic fluid embolism in which CT revealed an acute respiratory distress syndrome-like shadow.