Amniotic Fluid Embolus-like Syndrome Presenting in the Second Trimester of Pregnancy

Two cases of sudden cardiopulmonary embarrassment and profound disseminated intravascular coagulation occurring in the second trimester of pregnancy are described and a third from the literature is reviewed. All 3 pregnancies were complicated by persistent uterine bleeding. With supportive care, all mothers survived with rapid and spontaneous resolution of the clotting abnormalities. It is speculated that the pathophysiology of this event involves an amniotic fluid embolus. At this time no specific recommendations for prevention or treatment can be made. Vigorous support of the mother appears to offer the best chance for a successful outcome. (Obstet Gynecol 61:31S, 1983)