Background

Amniotic fluid embolism (AFE) with cardiac arrest is an obstetric emergency with an exceedingly high maternal mortality. Early application of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide essential cardiopulmonary support, but its clinical value warrants further investigation.

Case report

This report describes the successful management of a 36-year-old parturient with advanced maternal age who sustained sudden cardiac arrest due to AFE during the second stage of labor. Immediately following arrest, the patient received high-quality CPR and achieved return of spontaneous circulation (ROSC) within four minutes. A multidisciplinary team initiated early VA-ECMO support with an anticoagulation-free strategy post-ROSC, acting as a critical bridging therapy to cardiopulmonary recovery. Although total hysterectomy was subsequently performed for refractory severe postpartum hemorrhage, the patient ultimately achieved complete recovery and was discharged without sequelae, including thromboembolic complications or severe neurological deficits.

Conclusions

This case demonstrates the feasibility and potential utility of early VA-ECMO as a resuscitative therapy for AFE-induced cardiac arrest. Its successful application in this setting justifies further evaluation of ECPR in peripartum emergencies.