Abstract:

The etiology of refractory postpartum hemorrhage vary greatly. A small number of cases are actually diagnosed as atypical amniotic fluid embolism. Since it is difficult to identify clinically and the condition is critical, the routine treatment for postpartum hemorrhage is often ineffective, seriously threatening the lives of the mother and the fetus. A case is reported in which a patient underwent sequential induction of labor with oxytocin and dinoprostone suppositories due to premature rupture of membranes at term. After the onset of labor, the labor progressed rapidly, fetal distress occurred, and severe postpartum hemorrhage occurred after vaginal assisted delivery. Multidisciplinary emergency treatment was promptly carried out, and the outcomes of the mother and the fetus were good. After the onset of labor, the patient's platelet count decreased, and unexplained severe coagulation dysfunction occurred shortly after delivery. It was considered to be disseminated intravascular coagulation (DIC)-type amniotic fluid embolism. A retrospective analysis of the diagnosis and treatment process of this patient reveals that it is very necessary to standardize the induction of labor measures for pregnant women with high-risk factors for amniotic fluid embolism. Abnormal signs after the onset of labor should be closely observed, amniotic fluid embolism should be identified in a timely manner, and emergency treatment measures should be taken promptly to ensure the safety of the mother and the infant.

Key words: Postpartum hemorrhage, Embolism, amniotic fluid, Term birth, Fetal membranes, premature rupture, Labor, induced, Oxytocin