Amniotic fluid embolism presents with sudden dyspnea, chest pain, hypotension, and coagulopathy. What is the immediate management?

Amniotic fluid embolism presents with sudden dyspnea, chest pain, hypotension, and coagulopathy. What is the immediate management?

• A. Immediate resuscitation, oxygenation, hemodynamic support, and rapid delivery if needed; call code and notify team.
• B. Observation and supplemental oxygen only.
• C. Initiate broad-spectrum antibiotics and observe.
• D. Elective cesarean delivery at once.

Answer: (A)

Amniotic fluid embolism is a sudden, life-threatening catastrophe that disrupts both breathing and circulation and often triggers disseminated intravascular coagulation. The priority is aggressive resuscitation with a focus on restoring oxygenation and circulating volume while coordinating a rapid, multidisciplinary response. Secure the airway and provide high-flow oxygen right away; be prepared for intubation if breathing deteriorates. Establish large-bore IV access and begin aggressive fluid resuscitation, using vasopressors as needed to support blood pressure. Since coagulopathy is common, activate the massive transfusion protocol and transfuse blood products (packed red blood cells, fresh frozen plasma, platelets) as guided by coagulation studies to treat DIC. Throughout, call a code and notify the obstetric, anesthesia, surgical, and neonatal teams to mobilize rapidly. Delivery may be necessary if the fetus is compromised or if ongoing delivery is deemed to improve maternal status; however, do not delay resuscitation for delivery. Immediate stabilization and swift team coordination are the most important steps to improve outcomes for both mother and baby.

Amniotic fluid embolism is a sudden, life-threatening catastrophe that disrupts both breathing and circulation and often triggers disseminated intravascular coagulation. The priority is aggressive resuscitation with a focus on restoring oxygenation and circulating volume while coordinating a rapid, multidisciplinary response.

Secure the airway and provide high-flow oxygen right away; be prepared for intubation if breathing deteriorates. Establish large-bore IV access and begin aggressive fluid resuscitation, using vasopressors as needed to support blood pressure. Since coagulopathy is common, activate the massive transfusion protocol and transfuse blood products (packed red blood cells, fresh frozen plasma, platelets) as guided by coagulation studies to treat DIC. Throughout, call a code and notify the obstetric, anesthesia, surgical, and neonatal teams to mobilize rapidly.

Delivery may be necessary if the fetus is compromised or if ongoing delivery is deemed to improve maternal status; however, do not delay resuscitation for delivery. Immediate stabilization and swift team coordination are the most important steps to improve outcomes for both mother and baby.