Amniotic fluid embolism is very rare. It usually occurs during late pregnancy but may occur when an abortion Abortion Induced abortion is the intentional ending of a pregnancy by surgery or medications. A pregnancy may be ended by surgically removing the contents of the uterus or by taking certain medications... read more is done during the first or second trimester. While rare, of women who die suddenly during labor, amniotic fluid embolism is one of the most likely causes.
Risk may be increased with
Older maternal age
Placenta with an abnormally firm attachment to the uterus (placenta accreta Placenta Accreta Placenta accreta is a placenta with an abnormally firm attachment to the uterus. Having had a cesarean delivery, having placenta previa (when the placenta covers the cervix) in the current pregnancy... read more )
Tear in the cervix
Forceps used during delivery
Symptoms of Amniotic Fluid Embolism
The fluid or tissue can cause a serious reaction in a pregnant 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 ). The risk of death is high.
Disseminated intravascular coagulation Disseminated Intravascular Coagulation (DIC) Disseminated intravascular coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets... read more is a common complication. In this disorder, small blood clots develop throughout the bloodstream, resulting in widespread bleeding with massive loss of blood. Emergency care is required.
Diagnosis of Amniotic Fluid Embolism
A doctor's evaluation
Prompt diagnosis and treatment of amniotic fluid embolism are essential. Doctors may do blood tests to check the function of certain proteins that help the blood to clot normally.
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 of Amniotic Fluid Embolism
Emergency care team
Cardiopulmonary resuscitation (CPR)
Medications used to induce contractions
Transfusion of blood and blood components
Amniotic fluid embolism is a life-threatening emergency and requires urgent care by a team of specialists with intensive care equipment.
Women with amniotic fluid embolism 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 medications to help the heart contract. CPR First-Aid Treatment for Cardiac Arrest 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 is often required.
If CPR does not resolve cardiac arrest in a pregnant woman, the baby may be delivered immediately using forceps or a vacuum device Operative Vaginal Delivery Operative vaginal delivery is delivery using a vacuum extractor or forceps. A vacuum extractor consists of a small cup made of a rubberlike material that is connected to a vacuum. It is inserted... read more , or cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more may be done. Delivery can be critical for survival of the woman and lifesaving for the fetus if the fetus is old enough to survive outside the uterus.
Women are given medications used to induce contractions to help avoid excessive bleeding.