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. Rapid respiratory failure occurs when your lungs cannot supply enough oxygen to your blood or remove enough carbon dioxide from it. Amniotic fluid probably enters the maternal circulation through the endocervical veins, the placental insertion site, or a site of uterine trauma. Once it reaches the maternal circulation, it can precipitate cardiogenic shock, respiratory failure, and, most likely, an inflammatory and anaphylactoid response.AFE is a diagnosis of exclusion and is made clinically.
Amniotic fluid embolism (AFE) is a rare event, but one that is responsible for approximately 10% of all maternal deaths. Regardless of treatment, it is associated with a very high mortality rate. While approximately 70% of maternal deaths caused by AFE are a result of cardiopulmonary collapse, the pathophysiology of the cardiopulmonary disturbance is not clearly understood. Almost all human hemodynamic data post-AFE were collected 1 h or more after the event , yet 25%–50% of the parturients die within the first hour of clinical presentation .