Amniotic fluid embolism: early findings of transesophageal echocardiography.

Amniotic fluid embolism (AFE) is a rare event, but one that is responsible for approximately 10% of all maternal deaths (1). Regardless of treatment, it is associated with a very high mortality rate (2). While approximately 70% of maternal deaths caused by AFE are a result of cardiopulmonary collapse (3), the pathophysiology of the cardiopulmonary disturbance is not clearly understood. Almost all human hemodynamic data post-AFE were collected 1 h or more after the event (4), yet 25%–50% of the parturients die within the first hour of clinical presentation (5,6). We present a case in which transesophageal echocardiography (TEE) was performed during the early course of AFE. The TEE findings provide additional information regarding the cardiopulmonary pathophysiology occurring during the very early phase of AFE.