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Amniotic Fluid Embolism

By

Julie S. Moldenhauer

, MD, Children's Hospital of Philadelphia

Last full review/revision Jul 2021
CLICK HERE FOR THE PROFESSONAL VERSION

Amniotic fluid embolism occurs when some amniotic fluid that contains cells or tissue from the fetus enters the woman’s bloodstream and causes a serious reaction in the woman. (Amniotic fluid is the fluid that surrounds the fetus in the uterus.) This reaction can damage the lungs and heart and cause excessive bleeding.

Amniotic fluid embolism is very rare. It usually occurs during late pregnancy but may occur when an abortion is done during the 1st or 2nd trimester.

Risk factors

Many women are exposed to cells and tissues from the fetus during labor and delivery, and the conditions that increase risk are much more common than amniotic fluid embolism. Thus, it is unclear why amniotic fluid embolism develops in some women and not others.

Risk is increased when

Symptoms

The fluid or tissue can cause a serious reaction in the woman. The reaction usually occurs during or shortly after labor and delivery. The woman may have a rapid heart rate, an irregular heart rhythm, low blood pressure, and difficulty breathing. She may stop breathing (respiratory failure Respiratory Failure Respiratory failure is a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide in the blood becomes dangerously high. Conditions that block... read more ), or her heart may stop (cardiac arrest Cardiac Arrest and CPR Cardiac arrest is when the heart stops pumping blood and oxygen to the brain and other organs and tissues. Sometimes a person can be revived after cardiac arrest, particularly if treatment is... read more Cardiac Arrest and CPR ). About 20% of women with amniotic fluid embolism die.

Diagnosis

  • A doctor's evaluation

Prompt diagnosis and treatment of amniotic fluid embolism are essential.

Doctors diagnose amniotic fluid embolism based on symptoms, particularly when a woman has the following symptoms:

  • Sudden stopping of the heart

  • Sudden difficulty breathing

  • Low blood pressure

  • Widespread, uncontrolled bleeding

Treatment

  • Supportive care

Women may be given a transfusion of blood and blood components. Injection of a blood clotting factor (which helps blood clot) may be lifesaving. Women may require assistance with breathing or drugs to help the heart contract.

The baby may be delivered immediately using forceps or a vacuum extractor, or cesarean delivery may be done. Such a delivery does not appear to improve or worsen the woman's outcome. However, it may be lifesaving for the fetus if the fetus is old enough to survive outside the uterus.

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSONAL VERSION
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Postpartum depression is a feeling of extreme sadness and related psychologic disturbances after delivery of a baby. Although it is common to feel sad or miserable within 3 days of delivery (the baby blues), these feelings usually go away within 2 weeks. Postpartum depression is a more serious mood change. Women in which of the following groups are at increased risk for this condition?
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