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. Rapid respiratory failure occurs when your lungs cannot supply enough oxygen to your blood or remove enough carbon dioxide from it. Several factors have been associated with amniotic fluid embolism syndrome. They include precipitous or tumultuous labor, advanced maternal age, cesarean and instrumental delivery, placenta previa and abruption, grand multiparity (≥5 live births or stillbirths), cervical lacerations, fetal distress, eclampsia, and medical induction of labor.
AFE is a diagnosis of exclusion and is made clinically. It requires a high index of suspicion on clinical criteria, as above. International comparison shows that the mortality rate in British Columbia is among the best in the world, lower than Japan (8 per 100 000), Norway (11 per 100 000), the US (14 per 100 000), Russia (45 per 100 000), or Mexico (60 per 100 000). Although improvements are still possible, we can be proud of the current rates in this province.