{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:50:28Z","timestamp":1791971428092,"version":"4.3.4"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Amniotic fluid embolism (AFE) is a critical obstetric complication characterized\n                    by the entry of amniotic fluid and its components into maternal circulation\n                    during parturition, leading to acute cardiopulmonary failure, disseminated\n                    intravascular coagulation (DIC), and anaphylactic shock. Affected patients\n                    typically exhibit abrupt onset, rapid progression, and exceedingly high\n                    mortality. Early recognition and prompt intervention are pivotal in AFE\n                    management. We present a case of AFE-induced cardiac arrest in a 35-year-old\n                    primigravida who developed acute cardiopulmonary collapse during vaginal\n                    delivery, followed by cardiac arrest. After cardiopulmonary resuscitation,\n                    massive transfusion, and crash emergency cesarean section, anticoagulant-free\n                    venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated.\n                    Subsequent multimodal therapies \u2013 including aggressive transfusion support,\n                    uterine artery embolization for hemostasis, exploratory laparotomy, and targeted\n                    DIC management \u2013 ensured safe ECMO maintenance without device-related\n                    complications. By hospital day 3, hemodynamic and respiratory stability were\n                    achieved, enabling successful ECMO weaning. This case highlights that ECMO\n                    remains a viable therapeutic option for salvaging critically ill AFE patients\n                    with refractory hemorrhagic shock, DIC, and cardiopulmonary failure.<\/jats:p>","DOI":"10.1055\/a-2685-9833","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:57:25Z","timestamp":1757113045000},"page":"137-142","source":"Crossref","is-referenced-by-count":2,"title":["Management of Amniotic Fluid Embolism (AFE) using\n                    anticoagulation-free ECMO"],"prefix":"10.1055","volume":"230","author":[{"given":"Peijie","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Weifang People's Hospital, Shandong Second Medical University, Weifang, China"},{"name":"School of Clinical Medicine, Shandong Second Medical\n                    University, Weifang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuihua","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Weifang People's Hospital, Shandong Second Medical University, Weifang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Weifang People's Hospital, Shandong Second Medical University, Weifang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Weifang People's Hospital, Shandong Second Medical University, Weifang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Weifang People's Hospital, Shandong Second Medical University, Weifang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Weifang People's Hospital, Shandong Second Medical University, Weifang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e1002976","DOI":"10.1371\/journal.pmed.1002976","article-title":"Amniotic fluid embolism: A puzzling and dangerous obstetric problem","volume":"16","author":"S Lisonkova","year":"2019","journal-title":"PLoS Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1002\/ehf2.14254","article-title":"Amniotic fluid embolism-induced cardiopulmonary collapse successfully treated\n                    with combination VA-ECMO and Impella CP","volume":"10","author":"H Golzarian","year":"2023","journal-title":"ESC Heart Fail"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1111\/1471-0528.13300","article-title":"Incidence, risk factors, management and outcomes of amniotic-fluid embolism: a\n                    population-based cohort and nested case-control study","volume":"123","author":"K E Fitzpatrick","year":"2016","journal-title":"BJOG"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"B16","DOI":"10.1016\/j.ajog.2016.03.012","article-title":"Amniotic fluid embolism: diagnosis and management","volume":"215","author":"L D Pacheco","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e55961","DOI":"10.7759\/cureus.55961","article-title":"A case of consumptive coagulopathy before cardiopulmonary failure in amniotic\n                    fluid embolism and review of literature: A perspective of the latent onset and\n                    progression of coagulopathy","volume":"16","author":"T Oda","year":"2024","journal-title":"Cureus"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e22475","DOI":"10.7759\/cureus.22475","article-title":"Recurrent cardiac arrests due to amniotic fluid embolism","volume":"14","author":"M Barakat","year":"2022","journal-title":"Cureus"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.bpobgyn.2022.06.004","article-title":"Acute respiratory distress and amniotic fluid embolism in pregnancy","volume":"85","author":"T T Lao","year":"2022","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.26355\/eurrev_202102_25073","article-title":"Immune storm and coagulation storm in the pathogenesis of amniotic fluid\n                    embolism","volume":"25","author":"R L Yang","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1097\/MAT.0000000000002269","article-title":"Extracorporeal membrane oxygenation in amniotic fluid embolism: A systematic\n                    review of case reports","volume":"71","author":"NH K Trieu","year":"2025","journal-title":"ASAIO J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s13054-022-03969-3","article-title":"Amniotic fluid embolism rescued by venoarterial extracorporeal membrane\n                    oxygenation","volume":"26","author":"S Aissi James","year":"2022","journal-title":"Crit Care"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.bjae.2018.05.002","article-title":"Amniotic fluid embolism","volume":"18","author":"Y Metodiev","year":"2018","journal-title":"BJA Educ"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e24490","DOI":"10.7759\/cureus.24490","article-title":"Amniotic fluid embolism after first-trimester abortion","volume":"14","author":"S Panda","year":"2022","journal-title":"Cureus"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s12959-023-00452-z","article-title":"Current and future strategies to monitor and manage coagulation in ECMO\n                    patients","volume":"21","author":"S Zeibi Shirejini","year":"2023","journal-title":"Thromb J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s13054-020-2726-9","article-title":"Clinical controversies in anticoagulation monitoring and antithrombin\n                    supplementation for ECMO","volume":"24","author":"M M Chlebowski","year":"2020","journal-title":"Crit Care"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.2147\/JBM.S273047","article-title":"DIC in pregnancy \u2013 pathophysiology, clinical characteristics, diagnostic scores,\n                    and treatments","volume":"13","author":"O Erez","year":"2022","journal-title":"J Blood Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"497","DOI":"10.5505\/tjtes.2018.33802","article-title":"Heparin-free veno-venous ECMO applied to a patient with severe lung contusion\n                    and hypovolemic shock due to trauma","volume":"24","author":"S H Moon","year":"2018","journal-title":"Ulus Travma Acil Cerrahi Derg"}],"container-title":["Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2685-9833.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T22:33:00Z","timestamp":1776119580000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2685-9833"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":16,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,4,13]]},"published-print":{"date-parts":[[2026,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2685-9833","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0948-2393","1439-1651"],"issn-type":[{"value":"0948-2393","type":"print"},{"value":"1439-1651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}