Abstract

ALMAGUER ALMAGUER, José A. et al. Amniotic fluid embolism vs primary pulmonary hypertension: A case report. Rev Cubana Obstet Ginecol [online]. 2007, vol.33, n.3, pp. 0-0. ISSN 1561-3062.

The amniotic fluid embolism still shows an elevated mortality. In spite of the fact that some patients survive, the probabilities of dying are higher than those of surviving, according to the statistics. It has an incidence of 1 x 30 000 deliveries and the mortality rate is over 80 %. The clinical picture varies according to amount of amniotic fluid and to the suddenness with which it goes to the maternal bloodstream. The diagnosis is established by the presence of fetal squamous cells and mucins in the maternal pulmonary arteries. This finding is neither sensitive nor specific for the diagnosis. The case of a multiparous pregnant of 38.4 weeks with previous history of hereditary familiar lymphocytosis, erythrophagocytic histiocytosis, splenectomy and anemia with pelvic presentation   was reported. Labor was initiated and a clinical picture of piloerection, headache, cyanosis, chills, hypotension and weak pulse started. Emergent surgery was performed, the live newborn was extracted, and the patient continued with the same clinical picture, more bleeding through the vagina and punctures, and altered coagulogram and platelets. It was interpreted as an embolism of the amniotic fluid and disseminated intravascular coagulation (DIC). The patient died and the pathological anatomy department informed as a basic cause primary pulmonary hypertension and pregnancy plus CID. This diagnosis generated an intense polemic that led us to make this review.   

Keywords : Pregnancy; amniotic fluid embolism; primary pulmonary hypertension; maternal mortality.

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