Successful Venoarterial Extracorporeal Membrane Oxygenation Treatment in a Pregnant Woman with Amniotic Fluid Embolism

Abstract

Amniotic fluid embolism (AFE) is a rare, but catastrophic, obstetric complication with a high mortality rate. Moreover, >50% of maternal deaths occur within 1 h of symptom development. Further, it involves a high perinatal mortality rate, with 50% of affected neonates presenting neurological impairments. AFE is characterized by cardiovascular collapse, respiratory failure, and coagulopathy, followed by encephalopathy, multi-organ failure, and fetal distress. Therefore, its treatment strategy includes cardiopulmonary support, massive transfusion, and early cesarean section. However, venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used in cases with rapid progression of cardiac dysfunction, which has significantly decreased the maternal mortality rate. Therefore, VA-ECMO has been accepted as a useful treatment method for patients with AFE, including cardiac dysfunction. This article describes a case in which a patient with AFE was successfully treated with VA-ECMO and presents a literature review.