Amniotic fluid embolism suspected in a case of seizure and mild uterine haemorrhage with activation of coagulation and fibrinolysis

After a normal pregnancy and tabour in a 29-year-old parturient, a single seizure followed by a transient headache was observed during the uterine revision for placental retention. Mild uterine haemorrhage of 150 ml per hour without any uterine atony was associated with activation of clotting and fibrinolysis (decrease of fibrinogen, elevated fibrin soluble complexes and D-dimers). A ten fold value of foetal blood cells in maternal serum suggested the diagnosis of amniotic fluid embolism. Atypical forms of amniotic fluid embolism and their diagnosis are discussed. (C) 2003 Elsevier SAS. Tons droits reserves.