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What Is an Amniotic Fluid Embolism?

A woman experiencing an amniotic fluid embolism will be given an IV as part of her treatment.
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  • Written By: D. Jeffress
  • Edited By: Jenn Walker
  • Last Modified Date: 05 August 2014
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An amniotic fluid embolism is a very rare medical problem that can become life-threatening to a pregnant woman and her fetus. Complications occur when amniotic fluid or stray fetal cells escape the placenta and enter circulation in the mother's bloodstream. Her immune system treats the foreign substance as a pathogen, releasing histamines and other chemicals that elicit an allergic response. As a result, the mother can suffer lung failure, heart failure, and brain damage that can ultimately lead to death without emergency medical care.

Doctors have not identified any clear causes, risk factors, or early warning signs of amniotic fluid embolism. Since the condition is so rare, there have not been many major research projects dedicated to uncovering potential causes. It appears that women over the age of thirty are at a slightly increased risk, as are patients who have allergies. An amniotic fluid embolism usually develops shortly before, during, or after labor, though it is possible to experience problems as early as the second trimester of pregnancy.

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The immune system response to an amniotic fluid embolism is similar to what happens when a person has a severe allergy attack. A woman goes into anaphylactic shock as histamines cause inflammation of the airways, heart, and vital blood vessels. One of the first signs of an amniotic fluid embolism is extreme, sudden shortness of breath that may precede a collapsed lung. As the heart becomes more involved, dangerously low blood pressure and cardiac failure become likely. Heavy internal bleeding, seizures, coma, and fetal distress may also occur.

Immediate medical attention is needed whenever a patient shows symptoms of an amniotic fluid embolism. The main goal is to stabilize breathing and heart rate with oxygen therapy, cardiopulmonary resuscitation, medications, and intravenous fluids. Anti-inflammatory drugs and antihistamines may be given as well. Labor is induced right away via cesarean section to free the infant from the womb and treat him or her according to symptoms. A majority of babies are able to recover, though only about 20 to 40 percent of mothers survive even with expert care.

Women who are able to make it through the acute phase of an amniotic fluid embolism typically require long-term care and monitoring to combat various complications. Lung and heart problems may persist for several days or weeks, and any neurological damage suffered is often permanent. Survivors need to attend regular health checkups to make sure problems do not arise in the future.

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Discuss this Article

fify
Post 4

@anamur-- I don't think there is a consensus.

I'm not an expert so please talk to a physician about this foremost. But I imagine that if the embolism is caused by the mother going into labor, the risk might be reduced by planning for a c-section before the mother goes into labor herself. But since no one knows what really causes an embolism, there are no guarantees. And the article did mention that it could even happen in the second trimester.

If I were your sister, I would think hard and long before getting pregnant again. The percentage of amniotic fluid embolism survivors is low, your sister is one of the lucky ones. For someone who's already experienced it once, that's a huge risk to take. I personally don't think it would be worth it.

turquoise
Post 3

@anamur-- At the hospital I work, there was a woman who passed away several years ago due to amniotic fluid embolism. Her symptoms also started as she entered labor and she soon went into anaphylactic shock. The doctors did their best to save her, she didn't respond to anything. They were able to save the baby thankfully.

This woman did not have induced labor, and she was giving birth to her second child. She had delivered her first child without any problems. So I don't think that induced labor is the only cause for AFE.

And it really is such a rare condition. It is said that one out of every thirty thousand pregnant woman experience it. I'm glad that it's rare, but it does make it difficult to determine amniotic fluid embolism risk factors as the article said.

serenesurface
Post 2

@anon108724-- It's interesting you say that because my sister also had an amniotic fluid embolism during induced labor. She was apparently fine until the labor started and then she started showing embolism symptoms.

We are really lucky because they were able to get the baby out with a c-section and rush my sister for intensive medical care in another part of the hospital. She had to receive blood and was under doctor control in the hospital for several days. I realize that things could have been a lot worse and we could have lost my sister and my niece that day.

Is there consensus among physicians about induced labor leading to or increasing the risk for AFE?

And if my sister were to get pregnant again and have natural birth without induced labor, would she again experience AFE? She is obviously not willing to take such a risk right now. But I'm wondering if having experienced AFE once puts her at higher risk of experiencing it again, if the culprit is in fact induced labor?

anon108724
Post 1

More often then not, AFE is caused by inducing labor, with epidurals or cytotec.

Take a look at the Safe Motherhood Quilt Project.

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