A 30-year-old woman experiences sudden severe dyspnea, hypotension (BP 80/50), and cyanosis during active labor. Minutes later, she develops profuse bleeding from intravenous sites and gingival oozing. Vital signs show tachycardia (HR 128/min), tachypnea (RR 22/min), and SpO2 88% on room air. Laboratory studies reveal thrombocytopenia (platelets 45,000/μL), prolonged PT (18 seconds) and PTT (52 seconds), and normal fibrinogen levels. She denies recent anticoagulant use. Which pathophysiologic mechanism most likely underlies this condition?
- A)Entry of fetal squamous cells and tissue factor into maternal circulationGABARITO
- B)IgE mediated mast cell degranulation
- C)Acute left ventricular failure due to papillary muscle rupture
- D)Cholesterol embolization after vascular surgery
- E)Pulmonary thromboembolism from deep veins
Explicação
Amniotic fluid embolism occurs when fetal squamous cells and thromboplastic material enter the maternal circulation during labor or the immediate postpartum period. This can trigger sudden cardiopulmonary collapse and disseminated intravascular coagulation. Ver explicação completa e trilha adaptativa →