{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:21:58Z","timestamp":1782260518522,"version":"3.54.5"},"reference-count":17,"publisher":"AACN Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,1]]},"abstract":"<jats:p>Amniotic fluid embolism is a rare syndrome with potentially lethal outcomes. Complications include cardiorespiratory failure, disseminated intra-vascular coagulation, seizures, neurological deficits, and death. A 34-year-old woman had amniotic fluid embolism complicated by paradoxical embolism and disseminated intravascular coagulation. Emergency cesarean section followed by cardiopulmonary bypass with removal of the clot from the atria and closure of the patent foramen ovale was performed, resulting in a good outcome for both the mother and the baby. Subsequent treatment with anticoagulants for 6 months was recommended. A literature review revealed that this clinical scenario is rare but can be successfully managed by cardiopulmonary bypass and thromboembolectomy. Data on guidelines for the use of anticoagulation in this situation are limited.<\/jats:p>","DOI":"10.4037\/ajcc2009957","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T02:04:44Z","timestamp":1242180284000},"page":"379-382","source":"Crossref","is-referenced-by-count":10,"title":["Amniotic Fluid Embolism Complicated by Paradoxical Embolism and Disseminated Intravascular Coagulation"],"prefix":"10.4037","volume":"19","author":[{"given":"Sumeet","family":"Kumar","sequence":"first","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"Wong","sequence":"additional","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Maysky","sequence":"additional","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Shulman","sequence":"additional","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Olenchock","sequence":"additional","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Falzon-Kirby","sequence":"additional","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thein H.","family":"Oo","sequence":"additional","affiliation":[{"name":"All authors are on staff at Caritas St Elizabeth\u2019s Medical Center, Tufts University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"key":"2019112522091343400_R1","doi-asserted-by":"crossref","unstructured":"Morgan M . Amniotic fluid embolism. Anaesthesia. 1979; 34(1):20\u201332.","DOI":"10.1111\/j.1365-2044.1979.tb04862.x"},{"key":"2019112522091343400_R2","doi-asserted-by":"crossref","unstructured":"Clark SL , Hankins GD, Dudley DA, Dildy GA, Porter TF. Amniotic fluid embolism: analysis of a national registry. Am J Obstet Gynecol. 1995;172(4 pt 1):1158\u20131169.","DOI":"10.1016\/0002-9378(95)91474-9"},{"key":"2019112522091343400_R3","unstructured":"Gilbert WM , Danielsen B. Amniotic fluid embolism: decreased mortality in a population-based study. Obstet Gynecol. 1999; 93(6):973\u2013997."},{"key":"2019112522091343400_R4","doi-asserted-by":"crossref","unstructured":"Koullias GJ , Elefteriades JA, Wu I, et al. Images in cardiovascular medicine. Massive paradoxical embolism: caught in the act. Circulation. 2004;109(24):3056\u20133067.","DOI":"10.1161\/01.CIR.0000132371.91318.6D"},{"key":"2019112522091343400_R5","doi-asserted-by":"crossref","unstructured":"Shechtman M , Ziser A, Markovits R, Rozenberg B. Amniotic fluid embolism: early findings of transesophageal echocardiography. Anesth Analg. 1999;89(6):1456\u20131458.","DOI":"10.1213\/00000539-199912000-00025"},{"key":"2019112522091343400_R6","doi-asserted-by":"crossref","unstructured":"Rufforny-Doudenko I , Sipp C, Shehata BM. Pathologic quiz case. A 30-year-old woman with severe disseminated intravascular coagulation during delivery. Arch Pathol Lab Med. 2002;126(7):869\u2013870.","DOI":"10.5858\/2002-126-0869-PQCAYO"},{"key":"2019112522091343400_R7","doi-asserted-by":"crossref","unstructured":"Porat S , Leibowitz D, Milwidsky A, Valsky DV, Yagel S, Anteby EY. Transient intracardiac thrombi in amniotic fluid embolism. BJOG. 2004;111(5):506\u2013510.","DOI":"10.1111\/j.1471-0528.2004.00102.x"},{"key":"2019112522091343400_R8","unstructured":"Reis RL , Pierce WS, Behrendt DM. Haemodynamic effects of amniotic fluid embolism. Surg Gynecol Obstet. 1969; 129(1):45\u201348."},{"key":"2019112522091343400_R9","doi-asserted-by":"crossref","unstructured":"Rodgers BM , Staroscik RN, Reis RL. Effects of amniotic fluid on cardiac contractility and vascular resistance. Am J Physiol. 1971;220(6):1979\u20131982.","DOI":"10.1152\/ajplegacy.1971.220.6.1979"},{"key":"2019112522091343400_R10","doi-asserted-by":"crossref","unstructured":"Hankins GD , Snyder RR, Clark SL, Schwartz L, Patterson WR, Butzin CA. Acute hemodynamic and respiratory effects of amniotic fluid embolism in the pregnant goat model. Am J Obstet Gynecol. 1993;168(4):1113\u20131129.","DOI":"10.1016\/0002-9378(93)90355-M"},{"key":"2019112522091343400_R11","doi-asserted-by":"crossref","unstructured":"Fletcher SJ , Parr MJ. Amniotic fluid embolism: a case report and review. Resuscitation. 2000;43(2):141\u2013146.","DOI":"10.1016\/S0300-9572(99)00140-9"},{"key":"2019112522091343400_R12","doi-asserted-by":"crossref","unstructured":"Lockwood CJ , Bach R, Guha A, Zhou XD, Miller WA, Nemerson Y. Amniotic fluid contains tissue factor, a potent initiator of coagulation. Am J Obstet Gynecol. 1991;165 (5 pt 1):1335\u20131341.","DOI":"10.1016\/0002-9378(91)90363-V"},{"key":"2019112522091343400_R13","doi-asserted-by":"crossref","unstructured":"Courtney LD , Allington M. Effect of amniotic fluid on blood coagulation. Br J Haematol. 1972;22(3):353\u2013355.","DOI":"10.1111\/j.1365-2141.1972.tb05681.x"},{"key":"2019112522091343400_R14","doi-asserted-by":"crossref","unstructured":"Bauer P , Lelarge P, Hennequin L, Lambert H, Larcan A. Thromboembolism during amniotic fluid embolism. Intensive Care Med. 1995;21(4):384.","DOI":"10.1007\/BF01705419"},{"key":"2019112522091343400_R15","unstructured":"Kent KJ , Cooper BC, Thomas KW, Zlatnik FJ. Presumed antepartum amniotic fluid embolism. Obstet Gynecol. 2003;102(3):493\u2013495."},{"key":"2019112522091343400_R16","doi-asserted-by":"crossref","unstructured":"Esposito RA , Grossi EA, Coppa G, et al. Successful treatment of postpartum shock caused by amniotic fluid embolism with cardiopulmonary bypass and pulmonary artery thromboembolectomy. Am J Obstet Gynecol. 1990;163(2):572\u2013574.","DOI":"10.1016\/0002-9378(90)91200-V"},{"key":"2019112522091343400_R17","doi-asserted-by":"crossref","unstructured":"Stanten RD , Iverson LI, Daugharty TM, Lovett SM, Terry C, Blumenstock E. Amniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass. Obstet Gynecol. 2003;102(3):496\u2013498.","DOI":"10.1097\/00006250-200309000-00013"}],"container-title":["American Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/aacnjournals.org\/ajcconline\/article-pdf\/19\/4\/379\/93569\/379.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/aacnjournals.org\/ajcconline\/article-pdf\/19\/4\/379\/93569\/379.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T09:12:12Z","timestamp":1633425132000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article\/19\/4\/379\/5547\/Amniotic-Fluid-Embolism-Complicated-by-Paradoxical"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7,1]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2010,7,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ajcc2009957","relation":{},"ISSN":["1062-3264","1937-710X"],"issn-type":[{"value":"1062-3264","type":"print"},{"value":"1937-710X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,7,1]]}}}