This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains. The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema. The most likely clinical diagnosis is: \nSelect and explain. \nA. Rupture of uterus, B. Congestive heart failure, C. Amniotic fluid embolism, D. Concealed accidental hemorrhage', 'role': 'user'}, {'content': 'Answer: C \nExplanation: In the question, the female is :\n\nMultiparous\nAdvanced maternal age\nFetus is dead.\n\nThe patient is having strong uterine contractions and suddenly goes in shock with cyanosis, respiratory disturbance and pulmonary edema. All these favour the diagnosis of amniotic fluid embolism.\nAmniotic fluid embolism : It is characterised by an abrupt onset of respiratory distress and coagulopathy.\n\nAmniotic fluid enters the circulation and sets up a disseminated intravascular coagulation, leading to consumptive coagulopathy.\nClassically a woman in late labour or immediate postpartum gasps for air, has bronchospasm, becomes cyanotic and undergoes immediate collapse and cardiorespiratory arrest, usually accompanied by hemorrhage. Sudden death is usual.\nIt is diagnosed clinically.\n\nRisk factors:\n\nAdvanced maternal age\nTetanic uterine contraction\nUterine rupture\nPremature separation of placenta\nMultiparity\nUse of uterine stimulants\nCesarean section\nIntra uterine fetal death.', 'role': 'assistant'}]