Amniotic fluid embolism during cesarean section: a rare and catastrophic obstetric: a case report

Abstract

Amniotic fluid embolism (AFE) is a rare but catastrophic obstetric emergency characterized by sudden cardiovascular collapse, respiratory failure, and disseminated intravascular coagulation. It most commonly occurs during labour, cesarean section, or the immediate postpartum period and remains an important cause of maternal mortality worldwide. We report the case of a 28-year-old primigravida who developed sudden respiratory distress, hypoxemia, profound hypotension, and coagulopathy immediately following placental delivery during an emergency cesarean section under spinal anesthesia. The patient rapidly deteriorated and required endotracheal intubation, mechanical ventilation, aggressive fluid resuscitation, vasopressor support, and massive transfusion of blood products. Intraoperative chest radiography demonstrated diffuse bilateral pulmonary infiltrates consistent with acute pulmonary edema, supporting the clinical diagnosis of amniotic fluid embolism. Following multidisciplinary management in the intensive care unit, including ventilatory support and correction of disseminated intravascular coagulation, the patient recovered progressively, was successfully extubated after 48 hours, and was discharged without neurological sequelae. This case highlights the importance of early recognition, prompt multidisciplinary intervention, and aggressive supportive management in improving maternal outcomes in amniotic fluid embolism.