Emergency contrast enhanced chest computed tomography (CT) showed a pulmonary embolism on bilateral interlobar pulmonary arteries and segmental branches of both lower lobes ( Fig. We had tracheal intubation, infusion of crystalloids and vasopressors, blood component replacement, and other supportive measures. After five minutes of CPR, her cardiac rhythm was changed to a normal sinus rhythm. And her electrocardiogram was showed a pulseless electrical activity. On admission, her blood pressure was unable to be checked. So, immediate cardiopulmonary resuscitation (CPR) was performed by physician of that clinic in the ambulance. On the way to our hospital emergency room, she had stupor mental state and no pulse rate. The next day, she developed a sudden loss of consciousness and a low blood pressure of 70/50 mm Hg, and was transferred to Soonchunhyang University Cheonan Hospital for precise diagnosis and treatment. Key words: Cesarean section Heart arrest Pulmonary embolism PancreatitisĪ healthy 33-year-old female, with a normal antenatal course, underwent the uneventful cesarean section in a primary hospital at 38 weeks of gestation. Here, we report our case with a review of literatures. To our knowledge, our case is one of the most dangerous conditions after the cesarean section. We describe the consideration of amniotic fluid embolism with DIC as most appropriate in this case. She developed acute ischemic pancreatitis after cardiac arrest. Her condition was suitable disseminated intravascular coagulation (DIC). Immediate cardiac compression was performed and eventually resulted in good recovery of her heartbeat. Loss of consciousness occurred one day after cesarean section during her first ambulation. The patient underwent uneventful course on that day. A 33-year-old woman underwent elective repeat cesarean section at 38 weeks of gestation under spinal anesthesia. Obstetrical clinicians have low experience to these serious situations necessitating immediate first aid and knowledge of its differential diagnosis. Maternal treatment is primarily supportive, whereas prompt delivery of the mother who has sustained cardiopulmonary arrest is critical for improved newborn outcome.Cardiac arrest one day after cesarean section is extremely rare. Data regarding the presence of risk factors for amniotic fluid embolism are inconsistent and contradictory at present, no putative risk factor has been identified that would justify modification of standard obstetric practice to reduce the risk of this condition. Clinical series based on population or administrative databases that do not include individual chart review by individuals with expertise in critical care obstetrics are likely to both overestimate the incidence and underestimate the mortality of this condition by the inclusion of women who did not have amniotic fluid embolism. Progress in our understanding of this syndrome continues to be hampered by a lack of universally acknowledged diagnostic criteria, the clinical similarities of this condition to other types of acute critical maternal illness, and the presence of a broad spectrum of disease severity. This response and its subsequent injury appear to involve activation of proinflammatory mediators similar to that seen with the classic systemic inflammatory response syndrome. The pathophysiology appears to involve an abnormal maternal response to fetal tissue exposure associated with breaches of the maternal-fetal physiologic barrier during parturition. Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%.
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