Amniotic fluid embolism (AFE) is a rare obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enters the mother's blood stream via the placental bed of the uterus and trigger an allergic reaction. This reaction then results in cardiorespiratory (heart and lung) collapse and coagulopathy. Amniotic fluid embolism (AFE) is a pregnancy complication that causes life-threatening conditions, such as heart failure. It can affect you, your baby, or both of you.
The first stage of AFE usually includes cardiac arrest and rapid respiratory failure. Cardiac arrest occurs when your heart stops working and you lose consciousness and stop breathing. Other possible symptoms may also include fetal distress (signs that the baby is unwell including changes in the fetal heart rate or decreased movement in the womb), vomiting, nausea, seizures, severe anxiety, and skin discoloration.The pathophysiology of AFE is speculative, various theories have been published. In 1995, Clarke suggested that the syndrome arose from an immune rather than embolic process.
The estimated incidence of AFE is 1:15,200 and 1:53,800 deliveries in North America and Europe, respectively. The case fatality rate and perinatal mortality associated with AFE are 12–10% and 9–10%, respectively. Risk factors associated with an increased risk of AFE include advanced maternal age, placental abnormalities, operative deliveries, eclampsia, polyhydramnios, cervical lacerations, and uterine rupture.