A 32-year-old woman with no prior pulmonary history develops acute severe dyspnea, hypotension (BP 88/52), tachycardia (HR 128), and cyanosis (SpO2 88%) during labor shortly after spontaneous rupture of membranes. She subsequently develops diffuse bleeding from intravenous sites and petechiae. Chest X-ray shows bilateral infiltrates. Fibrinogen is markedly decreased at 95 mg/dL. She denies recent trauma or surgery. Which of the following is the most likely diagnosis?
- A)Eclampsia
- B)Pulmonary fat embolism
- C)Amniotic fluid embolismGABARITO
- D)Transfusion related acute lung injury
- E)Massive aspiration pneumonitis
Explicação
Amniotic fluid embolism is correct. Sudden cardiopulmonary collapse during labor or soon after delivery followed by disseminated intravascular coagulation is the classic presentation. Fetal squamous cells and inflammatory mediators enter the maternal circulati... Ver explicação completa e trilha adaptativa →