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Korean J Anesthesiol > Volume 33(4); 1997 > Article
Korean Journal of Anesthesiology 1997;33(4):778-783.
DOI: https://doi.org/10.4097/kjae.1997.33.4.778   
Amniotic Fluid Embolism during Dilatation and Curettage in a Second Trimesteric Missed Aborted Pregnant Patient.
Bong Il Kim, Seung Hee Paek, Woon Seok Rho, Sang Pyung Lee, Soung Kyung Cho, Sang Hwa Lee
Amniotic fluid embolism (AFE) is a rare but devasting obstetric emergency. We experienced a case of AFE during dilatation and curettage (D & C) in a 15 2/7 weeks pregnant woman, age 30, who was diagnosed as having a missed abortion. Sudden rapid hypoxemia, low SpO2, hypotension, low PETCO2, high CVP, and tachycardia, right axis deviation and right bundle branch block in 12 leads ECG were developed during D &C under general anesthesia, and signs of disseminated intravascular coagulation (DIC) followed after the operation, which are consistent with the findings of AFE. Even though there was no definite pathologic and radiologic confirmation of AFE, laboratory findings showed 100 times higher level of alpha-fetoprotein in her central venous blood than same weeks of missed abortion woman's blood. Though it is rare, the anesthesiologist should always suspect the possibility of AFE, when the patient shows an unexplained collapse, cyanosis, low PETCO2, high CVP, low SpO2, ECG change and DIC during any kind of obstetric procedure.
Key Words: Complications, amniotic fluid embolism; Surgery, dilatation and curretage
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