A 28 year old G3P2 parturient is undergoing general anaesthesia for emergency cesarean section due to uterine rupture. All these findings would suggest an amniotic fluid embolism pH except.
**Core Concept**
Amniotic fluid embolism (AFE) is a rare but catastrophic complication of pregnancy, often occurring during delivery or postpartum. It is characterized by the sudden onset of hypoxia, hypotension, and coagulopathy due to the entry of amniotic fluid into the maternal circulation.
**Why the Correct Answer is Right**
AFE typically presents with a triad of hypoxia, hypotension, and coagulopathy. The pH in AFE is often acidic due to the entry of acidic amniotic fluid into the maternal circulation, leading to a metabolic acidosis. This can be detected on arterial blood gas analysis, which would show a decreased pH, increased lactate levels, and a decreased bicarbonate level.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because a normal or slightly alkalotic pH would not be expected in AFE.
* **Option B:** This option is incorrect because a decreased pH is a hallmark of AFE, not an increased pH.
* **Option D:** This option is incorrect because while a decreased pH is expected in AFE, an increased base deficit would be expected, not a decreased one.
**Clinical Pearl / High-Yield Fact**
In AFE, the arterial blood gas analysis often shows a decreased pH, increased lactate levels, and a decreased bicarbonate level. This can be remembered as "BAD LABS" - Bad Acidosis, Dangerously Low pH, and Altered Blood Gas results.
**Correct Answer: B. Normal or slightly alkalotic pH would not be expected in amniotic fluid embolism.**