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Intrauterine Air Embolism Associated With a Rectovaginal Fistula in a Pregnant Woman

Hoppe, Kara K. DO; Fialkow, Michael F. MD, MPH; Dighe, Manjiri MD; Cheng, Edith MD, MS

doi: 10.1097/AOG.0b013e31821fcdb2
Case Reports
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BACKGROUND: Previous case reports have reported maternal and fetal mortality in pregnancies complicated by air emboli induced by various mechanisms.

CASE: A 33-year-old multiparous woman with a known rectovaginal fistula presented with symptoms of placental abruption. She subsequently was found to have a large intrauterine air embolus. The patient was treated successfully to term by continuously draining the vaginal air with a Malecot catheter.

CONCLUSION: We describe a rare case of an intrauterine air embolism during pregnancy caused by a rectovaginal fistula. Prompt recognition of air within the uterine myometrium and subchorionic space during ultrasonography led to the diagnosis and successful treatment of a potentially fatal complication by using an intravaginal Malecot catheter to release the trapped air.

Prompt recognition of air within the uterine myometrium and subchorionic space during ultrasonography led to the diagnosis and successful treatment of an intrauterine air embolism.

From the Departments of Obstetrics and Gynecology and Radiology, the University of Washington, Seattle, Washington.

Corresponding author: Kara Hoppe, DO, Department of Obstetrics and Gynecology, University of Washington, 1959 NE Pacific Avenue, Seattle, WA 98195; e-mail: khoppe2@u.washington.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists