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J Cases Obstet Gynecol, 2017;4(4):84-86
J o u r n a l o f C a s e s i n J o u r n a l o f C a s e s i n
Obs tetrics & G ynecology Obs tetrics & G ynecology
Case Report
with a right-sided pneumothorax should be evaluated for endometriosis is increasing considered to be a clinical di-
endometriosis, especially if significant pelvic symptomatol- agnosis [23], in woman investigated with laparoscopy, Near Miss Postpartum Woman with an Amniotic Fluid Embolism, a Rari-
ogy is present. The overlap between pelvic and thoracic en- scrupulous inspection of the diaphragm is warranted even ty Requiring Multidisciplinary Approach
dometriosis cannot be overstated. In a retrospective review if in the absence of a history of thoracic symptoms as this
of 156 women with women with pneumothorax, pelvic en- may identify some women at risk of future pneumothorax.
dometriosis symptoms were significantly more common in
those found to have thoracic endometriosis [14]. In symp- Acknowledgement Natalia Hanson¹*, Christopher Heron¹, Emil R. Szabo²
tomatic women who went on to laparoscopy, 80% had con- None
firmed pelvic endometriosis. Moreover, if surgical man- Declaration of Interest 1 Department of Family Medicine, Penn State Health Milton S. Hershey Medical Center, Mount Nittany Medical Center,1850 East Park Ave, Suite 207, State College,
agement is undertaken, gynecologic consultation should be R.L.R has been consultant to Allergan, Aspen and Bayer and has served PA, 16803, United States
2
Department of Obstetrics- Gynecology, Solo Practitioner, 251 Easterly Parkway, State College, PA, 16801, United States
considered both intraoperatively and in follow up. While on the Data and Safety Monitoring Board for Merck.
Abstract
An amniotic fluid embolism (AFE) is a condition with one of the highest pregnancy- associated mortality rates, accounting for 5-15% of pregnancy-re-
lated deaths worldwide. This article describes a case of a 36- year- old G4P1 at 38 weeks of gestation who underwent a planned Cesarean section for
a placenta previa which was complicated by cardiac arrest and disseminated intravascular coagulopathy secondary to a suspected AFE. The patient
was treated with a multidisciplinary approach, rapid response to alterations in vital stability and factor VII. The unpredictable nature of AFE and the
gravity of its sequelae warrant high suspicion in those at risk for AFE, as early recognition and prompt treatment can improve morbidity and mortality.
Key Words:
References Amniotic fluid embolism, disseminated intravascular coagulation, vaginal bleeding, factor VII
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The child was born with an APGAR of 8/9 at 0804. At
*Correspondence: Natalia Hanson
Address: Penn State Health Milton S. Hershey Medical Center, 0805 the patient developed seizure-like activity and be-
Mount Nittany Medical Center,1850 East Park Ave, Suite 207, State came unresponsive. She was intubated, received Atro-
College, PA, 16803, United States
Tel: 8144241230
Fax: 8142352482
e-mail: nhanson@hmc.psu.edu
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