Massive amniotic fluid embolism.

A patient at 42 weeks of pregnancy called the emergency department complaining of painful uterine contractions for six hours. She was advised to come to the hospital immediately. An episode of vomiting caused a 60-minute delay in her arrival. Dyspnea, fatigue, and leg cramps developed. In the emergency department she was anxious, alert, and cyanotic. Fetal distress was diagnosed. Within 15 minutes the patient had bradycardic cardiopulmonary arrest. Resuscitation attempts and agonal caesarean section failed. Autopsy revealed massive pulmonary amniotic fluid emboli. Amniotic fluid embolus must be considered in the differential diagnosis of pregnant patients with complaints of shortness of breath and signs of shock with bradycardia.