CARDIOPULMONARY ARREST DURING CAESAREAN SECTION; AMNIOTIC FLUID EMBOLISM; CASE REPORT. Amniotik s?v? embolisine ba?l? olarak sezaryen s?ras?nda geli?en kardiyopulmoner arrest olgusu; Olgu sunumu.

摘要

Amniotic fluid embolism (AFE) occurs rarely. It is one of the major causes of maternal mortality in caesarean section. A 25-year-old primigravida was admitted for delivery at 39 weeks and 3 days gestation after a normal pregnancy. A live female infant weighing 2920 g was delivered. Then bradycardia and kardiac arrest occured.medical and obstetric management was started immediately. It was stopped inhalated agent and continued mechanical ventilation with 100% O2 concentration. Atropine 2 gr and adrenaline 2 gr were given. After resuscitation performed the patient’s blood pressure was 110/80 mmHg. At the end of surgery, after one hour of monitoring in the recovery room, the patient was transferred to the intensive care unit. The presentation of this syndrome was hypotension, massive bleeding and sudden cardiac arrest. Early diagnose and management are the key points for the favourable outcome. The final diagnosis was AFE leading to profuse post-partum haemorrhage sudden cardiac arrest.??? ??ZET Amniyotik s?v? embolisi nadiren g?rülür. Sezaryen anne ?lümlerinin en ?nemli nedenlerinden biridir. 25 ya??nda, 39 hafta 3 gün ve ilk gebeli?i olan hasta sezaryen operasyonuna al?nd?.? 2920 gr a??rl???nda canl? bir k?z bebek do?du. Do?umu takiben ani bradikardi ve kardiyak arrest geli?en anneye hemen medikal ve obstetrik düzenlemeye ba?land?. ?nhalasyon ajan? durduruldu ve %100 O2 konsantrasyonu ile mekanik ventilasyona devam edildi.? Toplam olarak atropin 2 gr ve adrenalin 2 gr intraven?z olarak verildi. Resüsitasyona cevap al?nan hastan?n kan bas?nc? 110/80 mmHg idi. Operasyon sonras? uyanma odas?nda bir saat izlenen hasta yo?un bak?m ünitesine transfer edildi. Bu sendromda hipotansiyon, massif kanama ve ani kardiyak arrest geli?mesi tipiktir. Kesin tan?da? amniyotik mayi embolisinin yol a?t??? do?um sonras? kanama ve ani kardiyak arrest olmas? yolg?sterici olmal?d?r. Tedavide erken te?his ve tedavi en ?nemli anahtar noktalard?r.