J Reprod Med
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Case Reports
Amniotic fluid embolism treated with emergency extracorporeal membrane oxygenation: a case report.
Amniotic fluid embolism (AFE) is a rare disorder classically characterized by the abrupt onset of hypotension, hypoxia and consumptive coagulopathy during delivery or in the immediate postpartum period. It is postulated that amniotic fluid,fetal cells, hair or other debris enters the maternal circulation, causing cardiopulmonary collapse. The precise pathophysiologic mechanism remains elusive, treatment is supportive, and AFE carries a mortality of up to 80%. ⋯ Though there is no definitive treatment for AFE, ECMO provided oxygenation and allowed the patient to recover. ECMO may be useful in the treatment of severe cases of AFE.
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Torsion of adnexa usually manifests with severe abdominal pain and is treated as an acute surgical emergency. Asymptomatic torsion, necrosis and amputation of an ovary, and sometimes with other adnexal structures as well, are extremely rare. ⋯ Physicians should bear in mind the possibility of an autoamputated ovarian cyst even if the preoperative radiograph shows no calcification.