Case report of amniotic fluid embolism coagulopathy following abortion; use of viscoelastic point-of-care analysis

BMC Pregnancy Childbirth. 2020 Jan 3;20(1):9. doi: 10.1186/s12884-019-2680-1.

Abstract

Background: Amniotic fluid embolism (AFE) is a rare, life threatening obstetric complication, often associated with severe coagulopathy. Induced abortions are extremely safe procedures however complications including AFE can occur.

Case presentation: A 29-year-old previously healthy woman, gravida 1 para 0, presented for a scheduled second trimester induced abortion via dilation and evacuation at 22-weeks gestation. The case was complicated by a suspected AFE with associated profound coagulopathy. Viscoelastic point-of-care coagulation analysis was used to successfully and swiftly guide management of her coagulopathy.

Conclusion: AFE can occur in the setting of induced abortion. This case report suggests viscoelastic point-of-care coagulation analyzers may aid in the management of pregnancy-related coagulopathy by providing faster coagulation assessment than laboratory testing, and facilitating timely, targeted management of coagulopathy.

Keywords: Abortion; Amniotic fluid embolism; Case report; Coagulopathy; Thromboelastography; Viscoelastic point-of-care analysis.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Induced / adverse effects*
  • Adult
  • Blood Coagulation Disorders / complications
  • Blood Coagulation Disorders / diagnostic imaging*
  • Blood Viscosity
  • Elasticity Imaging Techniques / methods*
  • Embolism, Amniotic Fluid / diagnostic imaging*
  • Embolism, Amniotic Fluid / etiology
  • Female
  • Humans
  • Point-of-Care Systems*
  • Pregnancy
  • Pregnancy Complications, Hematologic / diagnostic imaging*
  • Pregnancy Complications, Hematologic / etiology