What's the most likely diagnosis?
- 37 year-old female in labor with hypotension and dyspnea
- Mitral valve prolapse
- Fat embolism
- Klebsiella pneumnoia
- Amniotic fluid embolism
- TB
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Answer:
4. Amniotic fluid embolism
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Amniotic Fluid Embolism
General Considerations
- Rare and frequently fatal obstetrical emergency occurring in the mother most often during labor resulting in profound hypotension and dyspnea
- Believed to be due to amniotic fluid, fetal cells and unknown substance(s) that are released into the maternal bloodstream due to a breach in the barrier between amniotic fluid and the maternal circulation
- Such material is not found in the maternal circulation of all patients with the syndrome and many patients with out the syndrome have such materials recovered
- Leads to an anaphylactoid reaction possibly mediated by the complement cascade