Amniotic fluid embolism nord national organization for. Afe develops after a relatively large amount of amniotic. Amniotic fluid embolism afe is a rare disorder classically characterized by the abrupt onset of hypotension, hypoxia and consumptive coagulopathy during delivery or in the immediate postpartum. Ddx in any women with sudden cardiovascular collapse or cardiac arrest seizures, severe respiratory difficulty or hypoxia, particularly if such events are followed by a coagulopathy that cannot be otherwise explained ddx long. Amniotic fluid embolism afe is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the. Society for maternalfetal medicine smfm with the assistance of luis d. This is a 38year old pregnant woman with amniotic sac ruptured, cervix with 5cm dilation, complaining of severe pain. The clinical presentation of amniotic fluid embolism is, in its classic form, dramatic. Amniotic fluid embolism is a rare but serious condition that occurs when amniotic fluid the fluid that surrounds a baby in the uterus during pregnancy or fetal material, such as fetal cells, enters the mothers bloodstream.
Evidencebased critical care, hyzy rc ed, springer, switzerland 2017. Our understanding of risk factors, diagnosis, treatment and prognosis is hampered by a lack of uniform. Amniotic fluid embolism gynecology and obstetrics msd manual. Amniotic fluid embolism afe is a rare and often fatal obstetric condition, characterized by sudden. Principles of early clinical management article pdf available in american journal of obstetrics and gynecology 2221 july 2019 with 233 reads how we measure reads. The reported incidence of afe varies because of a wide spectrum of presenting signs and symptoms, as well as lack of a standardized approach to diagnostic evaluation of patients with suspected afe. Case report death mechanism of amniotic fluid embolism was.
Excessive fluid administration should be avoided grade 1c. Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%. Let us be careful not to make the diagnosis of amniotic fluid embolism a waste basket for cases of unexplained death during labor. Amniotic fluid embolism critical care obstetrics wiley online. Amniotic fluid embolism is a condition that occurs because there is systemic reaction similar to that found in an allergic response to amniotic fluid or fetal cells or fetal tissue debris by the pregnant mother.
Aok a novel treatment for amniotic fluid embolism sukhdeep rathore bsn, rn, ccrn yekaterina shchapina bsn, rn, ccrn university of pennsylvania dnpna class of 2020. Amniotic fluid embolism during vaginal delivery under analgesia. Amniotic fluid embolism, cardiovascular collapse, dic, disseminated. Summary amniotic fluid embolism afe, although an uncommon obstetric disorder, has a high case fatality rate and remains a leading cause.
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