Transient osteoporosis of the hip in pregnancy resulting in bilateral fracture of the neck of the femur
2012
crosis scattered within the basal ganglia and around the third ventricle, and ischemic damage in all cerebellar nuclei examined. The placenta did not show amniotic embolus in the vessels of the chorionic plate. AFE is usually present in cases that combine maternal cardiovascular shock, neurological disorders, and hemorrhage with disseminated intravascular coagulopathy [1,2]. In the present case, the sudden onset of symptoms in the absence of other known causes immediately suggested AFE. Diagnosis can be made even if epithelial cells found in maternal blood cannot be proved to be fetal cells [1]. The increase in serum tryptase indicates mast cell degranulation, which is observed inconsistently in AFE [4]. Because the pregnancy proceeded without other notable events it seems likely that the ischemic fetal brain damage was caused by severe hypoxia during AFE. AFE can occur in the absence of labor during the second trimester of pregnancy and should be considered in the presence of sudden respiratory, neurological, or cardio-vascular distress. Fetal consequences can occur despite full maternal recovery.
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