Intrauterine air embolism associated with a rectovaginal fistula in a pregnant woman.

Abstract

Previous case reports have reported maternal and fetal mortality in pregnancies complicated by air emboli induced by various mechanisms. 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. 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.