Obstetric anaesthesia: amniotic fluid embolism: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Obstetric anaesthesia: amniotic fluid embolism

Sample item

During labour a multiparous woman suddenly develops dyspnoea, cyanosis, hypotension and seizure, followed by bleeding from the puncture sites. What is the cornerstone of management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Supportive resuscitation with oxygenation, circulatory support and correction of coagulopathy

The picture is amniotic fluid embolism, with acute cardiorespiratory collapse and disseminated intravascular coagulation at or near delivery. There is no specific antidote, so management consists of resuscitation, ventilation, vasopressors, early delivery when indicated and massive transfusion for coagulopathy. Maternal arrest is managed with CPR, left uterine displacement and perimortem caesarean delivery.

Option by option

  • A. Intravenous antibiotics alone

    Antibiotics do not address the haemodynamic and coagulation collapse.

  • B. Supportive resuscitation with oxygenation, circulatory support and correction of coagulopathy (correct)

    Correct. Supportive care and treating the coagulopathy are the basis of management.

  • C. Thrombolysis

    Thrombolysis would worsen bleeding in a patient with coagulopathy.

  • D. Immediate pericardiocentesis

    There is no tamponade in this scenario.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Supportive resuscitation with oxygenation, circulatory support and correction of coagulopathy. The picture is amniotic fluid embolism, with acute cardiorespiratory collapse and disseminated intravascular coagulation at or near delivery.

Why is "Intravenous antibiotics alone" not the answer?

Antibiotics do not address the haemodynamic and coagulation collapse.

Why is "Thrombolysis" not the answer?

Thrombolysis would worsen bleeding in a patient with coagulopathy.

Why is "Immediate pericardiocentesis" not the answer?

There is no tamponade in this scenario.

What concept does this question test?

It tests Obstetric anaesthesia: amniotic fluid embolism in Anaesthesia. There is no specific antidote, so management consists of resuscitation, ventilation, vasopressors, early delivery when indicated and massive transfusion for coagulopathy. Maternal arrest is managed with CPR, left uterine displacement and perimortem caesarean delivery.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Obstetric anaesthesia: amniotic fluid embolism?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.