Reyyan ÖZCAN TEMİZKAN, Şevki ÇELEN, Ayhan SUCAK, Sevtap HAMDEMİR

AMNİYON SIVI EMBOLİSİ SONRASI SAĞ KALIM : OLGU SUNUMU

Amniyon sıvı embolisi AFE gebelikte nadir görülen fakat çok ciddi seyirli bir komplikasyondur. İnsidansı 1:8000 ile 1:80000 arasında değişmektedir. Mortalite oranı %61-86 dır. Neonatal sağ kalım % 40-70’ dir.Vakamız sağlıklı 36 yaşında multigravid eylemin indüksiyonu için yatırılmış 39 haftalık gebeydi. Eylemin aktif fazında AFE gelişti. Başlangıç semptomu akut ve ciddi hipotansiyon, takiben periferal dolaşım kollapsı ,siya- noz ve akut solunum yetmezliğidir. Hasta acil olarak sezeryana alındı. Nörolojik olarak fetus sağlam olarak çıkarıldı sonrasında annede ciddi hemoraji ve DIC gelişti. Ciddi koagülopatiye rağmen hasta bir hafta içinde hastaneden taburcu edilebildi. Amniyon sıvı embolisi yönetimi çok zor olan nadir görülen fakat çok ciidi seyirli bir komplikasyondur. Bu sebeple AFE yönetimi deneyimli ve nitelikli hekimlerin bulunduğu multidisipliner hastanelerde yapılmalıdır.

Anahtar Kelimeler:

Amniyon sıvı embolisi, anaflaktik reaksiyon, koagülopati

REMAINING ALIVE AFTER AMNIOTIC FLUID EMBOLISM: A CASE REPOR

Amnion fluid embolism AFE is a rare but catastrophic complication of pregnancy. Its incidence varies from 1:8000 to 1:80.000 and the mortality rate is about 61 86%. Neonatal survival reaches 40-70% Our case was a healthy, 36 year old multigravida at 39 weeks gestation hospitalized for induction of labor, which developed AFE in the active phase of labor. Initial symptom was acute and severe hypotension, followed by collapse of peripheral circulation, cyanosis and acute respiratory failure. The patient underwent an urgent cesarean section with the survival of neurologically intact fetus but complicated with severe hemorrhage and DIC.Despite of severe coagulopathy, the mother was discharged from the hospital at the end of one week. Amniotic fluid embolism is a very complicated problem, difficult to manage. Complete management of AFE requires qualified, experienced and multidisciplinary physicians.

Keywords:

Amnion fluid embolism, anaphylactoid reactions, coagulopathy,

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