Defying the Odds: Survival After Amniotic Fluid Embolism and Extracorporeal Membrane Oxygenation Support

Abstract

Background: Amniotic fluid embolism is a rare potential complication in the peripartum period. Case Summary: A 27-year-old nulliparous woman presented for elective induction at 41 weeks' gestation. Due to nonreassuring fetal heart tracing, the patient underwent emergent caesarean section complicated by pulseless electrical activity arrest secondary to suspected amniotic fluid embolism after fetus delivery. Despite return of spontaneous circulation, the patient remained in cardiogenic shock with right ventricular failure. The patient was cannulated for venoarterial extracorporeal membrane oxygenation. After 5 days, she was converted to a right ventricular assist device, with ultimate complete biventricular recovery. Discussion: The use of multidisciplinary cardiogenic shock team aids in swift escalation of care in patients with refractory shock requiring mechanical circulatory support. It is crucial to initiate cardiogenic shock teams early in a patient's clinical course. Take-Home Messages: Amniotic fluid embolism is a known cause of mortality in postpartum women. Severe cases can lead to cardiac arrest. Rapid initiation of mechanical circulatory support can save lives.