![]() In 2016, uniform diagnostic criteria were proposed for reporting on cases of AFE. However, rapid diagnosis of AFE and immediate obstetric and intensive care has proven to play a decisive role in maternal prognosis and survival (7-9). Despite best efforts, it remains one of the leading causes of maternal death (1,5,6). Mortality rates vary but have been reported to range from 11% to more than 60%, with the most recent population-based studies in the United States reporting a 21.6% fatality rate (1-4). ![]() A literature review regarding the current recommendations for management of this condition follows as well as a proposed treatment algorithm.Īmniotic fluid embolus (AFE) is a rare and life-threatening complication of pregnancy a recent population-based review found an estimated incidence ranging from 1 in 15,200 deliveries in North America and 1 in 53,800 deliveries in Europe (1). The following case study demonstrates the importance of quick recognition as well as an interdisciplinary approach in caring for such a condition. If you have any queries at all, consult your doctor in order to receive safe and reliable information regarding your pregnancy.Ryan J Elsey DO 1*, Mary K Moats-Biechler OMS-IV 2, Michael W Faust MD 3, Jennifer A Cooley CRNA-APRN 4, Sheela Ahari MD 4, and Douglas T Summerfield MD 1ĭepartments of Internal Medicine 1,Obstetrics and Gynecology 3,and Anesthesia 4Īmniotic fluid embolus is a rare and life threatening peripartum complication that requires quick recognition and emergent interdisciplinary management to provide the best chance of a positive outcome for the mother and infant. Pregnant women should ensure that they have their health monitored by specialist obstetricians throughout their pregnancy as well as doing their best to maintain a positive state of mind, such as being careful to avoid any potentially stressful news that may pop up on social media accounts. Hence, sufficient time should be put aside for rehabilitation from the condition, with a slight chance that the subsequent symptoms may go away by themselves.Īlthough amniotic fluid embolisms can happen to anyone, with no way to predict or prevent them from occurring, the chances of a fatality due to an amniotic fluid embolism during a birth is only 1:20,000 among mothers worldwide. Furthermore they may vomit, suffer from shock and faint, with death being a very real possibility for both mother and child.Īdditionally, while doctors may be able to treat amniotic fluid embolism immediately, the after effects of the condition can be severe, by extending to the central nervous system and various other bodily systems. They will also see dark green discoloration of the nails and skin. Patient care should therefore primarily rely upon current obstetric standards of care.ĭuring the birthing process, mothers will feel restless, experience profuse perspiration, suffer from chest pain and have difficulty breathing. However, there is still no definitive evidence that any of the aforementioned risk factors play a role in causing amniotic fluid embolisms. Shock as a result of preeclampsia or fetal distress.Use of devices to aid the birthing process or caesarean section surgery.Placenta previa (abruptio placentae), a uterine rupture or vaginal injury.Encouraging a birth through the use of medication designed to stimulate contraction of the uterus.Mothers falling pregnant at an older age or becoming pregnant for at least the 5th time.Another possible cause could be the death of the fetus, causing a breakup of tissue which then enters into the bloodstream.Īside from these potential causes, there are numerous risk factors that could be associated with the condition: Alternately, an amniotic fluid embolism may occur due to a tear in the amniotic sac, leading to the leaking fluid entering the mother’s bloodstream. They may occur as a result of a severe restriction in the uterus, which causes a buildup of pressure in the womb that subsequently forces the amniotic fluid into the bloodstream. There are currently no proven causes of amniotic fluid embolisms.
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