Amniotic fluid embolism: a case report with a favorable outcome
A. V. Pyregov,
A. V. Gabova,
T. Sh. Mukhametov,
E. V. Nizhegorodov,
A. D. Kostyanyuk,
I. A. Sergeeva,
G. V. Alexandrov, 
O. F. Serova
O. F. Serova https://doi.org/10.24884/2078-5658-2025-22-4-93-101
Abstract
Introduction. Amniotic fluid embolism (AFE) is a rare but life-threatening complication of childbirth, characterized by the sudden development of arterial hypotension, hypoxia, shock and coagulopathic disorders. AFE is one of the most formidable and unpredictable complications of childbirth, accompanied by high mortality. Despite its rarity (1:8,000–1:80,000 births), AFE remains the leading cause of maternal mortality. Pathogenesis is associated with the entry of amniotic fluid into the maternal bloodstream, which leads to cardiopulmonary shock, DIC syndrome and multiple organ failure. Diagnosis of AFE is difficult due to its lightning-fast development and the lack of specific markers. Treatment requires immediate multidisciplinary intervention, including resuscitation, surgical hemostasis and correction of coagulopathy.
This article presents a case of a 34-year-old patient with risk factors (polyhydramnios, uterine scar, previous operative deliveries), who developed a clinical picture of EAF with multiple circulatory arrests, massive blood loss and multiple organ failure after an emergency cesarean section. The measures taken included cardiopulmonary resuscitation (CPR), surgery (ligation of uterine vessels, extirpation of the uterus, relaparotomy) and supportive therapy (plasmapheresis in the plasma exchange mode, ultrahemodiafiltration). Thanks to a timely multidisciplinary approach, a favorable outcome without neurological deficit was achieved.
Conclusion. This case demonstrates that with early diagnosis, surgical and complex treatment with dynamic laboratory monitoring, it is possible to achieve a favorable outcome even in severe EAF.
About the Authors
A. V. Pyregov
Moscow Regional Perinatal Center
Russian Federation
Russian Federation
Pyregov Alexey V., Dr. of Sci. (Med.), Professor Head of the Department of Anesthe siology, Resuscitation, and Intensive Care, Moscow Regional Children’s Clinical Research Institute of the Ministry of Health of the Moscow Region, Deputy Chief Physician for Anesthesiology and Resuscitation at the Moscow Regional Perinatal Center, Chief External Specialist in Anesthesiology and Resuscitation in Obstetrics of the Ministry of Health of the Moscow Region
12, Entuziastov shosse, Balashikha, 143903
A. V. Gabova
Moscow Regional Perinatal Center
Russian Federation
Russian Federation
Gabova Anna V., Assistant at the Department of Anesthesiology, Resuscitation, and Intensive Care, Moscow Regional Children’s Clinical Research Institute of the Ministry of Health of the Moscow Region, Head of the Women’s Anesthesiology and Intensive Care Department, Moscow Regional Perinatal Center
12, Entuziastov shosse, Balashikha, 143903
T. Sh. Mukhametov
Moscow Regional Perinatal Center
Russian Federation
Russian Federation
Mukhametov Timur Sh., Assistant at the Department of Anesthesiology, Resuscitation, and Intensive Care, Moscow Regional Children’s Clinical Research Institute of the Ministry of Health of the Moscow Region, Anesthesiologist and Intensivist at the Women’s Anesthesiology and Intensive Care Department, Moscow Regional Perinatal Center
12, Entuziastov shosse, Balashikha, 143903
E. V. Nizhegorodov
Moscow Regional Perinatal Center
Russian Federation
Russian Federation
Nizhegorodov Evgeny V., Anesthesiologist and Intensivist at the Women’s Anesthesiology and Intensive Care Department
12, Entuziastov shosse, Balashikha, 143903
A. D. Kostyanyuk
Moscow Regional Perinatal Center
Russian Federation
Russian Federation
Kostyanyuk Andrey D., Anesthesiologist and Intensivist at the Women’s Anesthesiology and Intensive Care Department
12, Entuziastov shosse, Balashikha, 143903
I. A. Sergeeva
Shchelkovo Perinatal Center
Russian Federation
Russian Federation
Sergeeva Irina A., Head of the Anesthesiology and Intensive Care Department of the Obstetric Hospital
6, Parkovaya str., Shchelkovo, Moscow region, 141100
G. V. Alexandrov
Shchelkovo Perinatal Center
Russian Federation
Russian Federation
Alexandrov Gennady V., Anesthesiologist and Intensivist at the Anesthesiology and Intensive Care Department of the Obstetric Hospital
6, Parkovaya str., Shchelkovo, Moscow region, 141100
O. F. Serova
Moscow Regional Perinatal Center; A. I. Burnazyan Federal Medical Biophysical Center
Russian Federation
Russian Federation
Serova Olga F., Dr. of Sci. (Med.), Professor, Head of the Department of Obstetrics, Gynecology, and Perinatology, A.I. Burnazyan Federal Medical Biophysical Center, Chief Physician, Moscow Regional Perinatal Center, Chief External Specialist in Obstetrics and Gynecology of the Ministry of Health of the Moscow Region
12, Entuziastov shosse, Balashikha, 143903
Zhivopisnaya str., 46, build. 8, Moscow, 123098
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For citations:
Pyregov A.V., Gabova A.V., Mukhametov T.Sh., Nizhegorodov E.V., Kostyanyuk A.D., Sergeeva I.A., Alexandrov G.V., Serova O.F. Amniotic fluid embolism: a case report with a favorable outcome. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2025;22(4):93-101. (In Russ.) https://doi.org/10.24884/2078-5658-2025-22-4-93-101
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