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Still during surgery, the mother underwent cardiac arrest. Transesophageal echocardiography during resuscitation showed right ventricular failure leading to the diagnosis of pulmonary embolism. Return of spontaneous circulation was achieved after emergency administration of thrombolysis with alteplase and cardiopulmonary resuscitation after 40\u2009min. Severe bleeding, coagulopathy and persistent right ventricular failure resulted in persistent hemodynamic instability leading to supracervical hysterectomy and veno\u2010arterial extracorporal life support. Both mother and baby survived without hypoxic brain injury.<\/jats:p>","DOI":"10.1002\/ccr3.9579","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T22:35:08Z","timestamp":1731710108000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dilemma Diagnosis Between Pulmonary Embolism and Amniotic Fluid Embolism During First Stage of Labor\u2014A Case Report"],"prefix":"10.1002","volume":"12","author":[{"given":"Kristina","family":"Killinger","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Riedel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Heidelberg University Hospital  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mascha 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