ANESTHESIOLOGISTS with a practice in obstetrics must be acutely aware of the differential
diagnosis of maternal cardiovascular collapse during pregnancy. The overall risk of
maternal death is 6.5 in 100,000 deliveries and typically occurs in the third trimester.
1
Deaths in the first and second trimesters are rare. The most common etiologies include
pre-eclampsia (16%), amniotic fluid embolism (AFE) (14%), hemorrhage (12%), cardiac
disease (11%), and pulmonary thromboembolism (9%). Less common etiologies include
infection, medication error, and ectopic pregnancy. There is great difficulty in distinguishing
between these disorders as they may have similar clinical presentations including
hypoxia, cardiovascular lability, bleeding, and neurologic manifestations such as
mental status changes and seizures.
1
Transesophageal echocardiography (TEE) may help guide the diagnosis and management
of cardiopulmonary collapse in pregnant patients.
2
,
3
The authors present a case of a 37-year-old female who was admitted for intrauterine
fetal demise (IUFD), which was complicated by cardiovascular collapse necessitating
cardiac surgery. Consent for this report was obtained from the patient.Key Words
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Article info
Publication history
Published online: August 16, 2016
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© 2016 Elsevier Inc. All rights reserved.
