A elderly gravida (G6P5) became disoriented, lightheaded, breathless, and cyanotic 20 minutes after an uncomplicated spontaneous vaginal term delivery. Her blood pressure is 80/40 mm Hg, pulse is 110/min, and respiratory rate is 30/min. O2 saturation is 75% on face mask.A generalized purpuric rash and bleeding from the I.V line site are seen. Which of the following is the most appropriate next step in management of this patient?
The above history is suggestive of Amniotic fluid Embolism - Treatment is mainly suppoive to correct the hypoxemia (eg, oxygen, intubation, mechanical ventilation) and hypotension (eg, vasopressors). Since this patient is in shock and is showing signs of hypoxia, immediate resuscitation in the form of intubation and mechanical ventilation is the next best step.
Abdominal ultrasound
Intramuscular magnesium sulfate
Intravenous heparin
Intubation and mechanical ventilation
Obstetrics