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Amniotic Fluid Embolism: A Life Threatening Condition

HIGHLIGHTS:

  • The chances of a mother losing her life to amniotic fluid embolism during birth currently stands at 1 in every 20,000 births worldwide.
  • Amniotic fluid embolism could affect anyone at any time, making it a condition that is impossible to prevent.
  • Pregnant mothers should try to stay as healthy as possible and attend regular appointments with a doctor. It is also advisable to stay positive by avoiding the stress that comes with too much time spent on social media. If you have any queries at all, consult your doctor in order to receive safe and reliable information regarding your pregnancy.

Amniotic fluid embolism (AFE) occurs as a result of the amniotic fluid or tiny parts of the fetus dislodging, entering the mother’s bloodstream and causing a blockage in the pulmonary veins. Such a blockage has a severe effect on the body’s immune system and can eventually cause the circulatory, respiratory or cardiovascular systems to fail.

Thus, amniotic fluid embolisms are classed as extremely dangerous. If they’re not treated in time, they can be fatal within an hour of their onset. Furthermore, the rate of fatalities for this condition stands at 80% for mothers, while the life of the baby being carried is also at risk in cases where the mother suffers an amniotic fluid embolism before giving birth and doctors are unable to immediately perform a cesarean section to save the baby.

Moreover, it is impossible to predict when or where the aforementioned condition may arise. Currently there no forms of prevention available.

Causes and risk factors

There are currently no proven causes of amniotic fluid embolisms. 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. 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. Another possible cause could be the death of the fetus, causing a breakup of tissue which then enters into the bloodstream.

Aside from these potential causes, there are numerous risk factors that could be associated with the condition:

  • Mothers falling pregnant at an older age or becoming pregnant for at least the 5th time
  • Encouraging a birth through the use of medication designed to stimulate contraction of the uterus
  • Placenta previa (abruptio placentae), a uterine rupture or vaginal injury
  • Use of devices to aid the birthing process or caesarean section surgery
  • Shock as a result of preeclampsia or fetal distress

However, there is still no definitive evidence that any of the aforementioned risk factors play a role in causing amniotic fluid embolisms. Patient care should therefore primarily rely upon current obstetric standards of care.

Symptoms

During the birthing process, mothers will feel restless, experience profuse perspiration, suffer from chest pain and have difficulty breathing. They will also see dark green discoloration of the nails and skin. Furthermore they may vomit, suffer from shock and faint, with death being a very real possibility for both mother and child.

Additionally, 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. 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.

Although 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.

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.

If you have any queries at all, consult your doctor in order to receive safe and reliable information regarding your pregnancy.


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Assoc. Prof. Boonsri Chanrachakul, M.D. Summary: Obstetrics And Gynaecology Maternal And Fetal Medicine