Amniotic fluid embolism

Question 1

What is amniotic fluid embolism?

Answer 1

• severe condition where amniotic fluid passes into mothers blood causing immune reaction from mother as it contains fetal tissue
• rare approx 2 in 100000
• usually occurs around labour and delivery (can be postpartum)
• has more similarities to anaphylaxis than venous thromboembolism
• mortality rate around 20% or above

Question 2

What are the main risk factors of amniotic fluid embolism?

Answer 2

• increasing maternal age
• induction of labour
• caesarean section
• multiple pregnancy

Question 3

How does amniotic fluid embolism present?

Answer 3

can present similarly to sepsis, pulmonary embolism or anaphylaxis, with an acute onset of symptoms of:

• Shortness of breath
• Hypoxia
• Hypotension
• Coagulopathy
• Haemorrhage
• Tachycardia
• Confusion
• Seizures
• Cardiac arrest

Question 4

What is the management of amniotic fluid embolism?

Answer 4

• supportive management
• is a medical emergency and likely need transfer to ICU

ABCDE approach
A-airway: secure the airway
B – Breathing: Provide oxygen for hypoxia
C – Circulation: IV fluids to treat hypotension and blood transfusion in haemorrhage
D – Disability: Treat seizures and consider other neurological deficits
E – Exposure

-Cardiopulmonary resuscitation and immediate caesarean section are required if cardiac arrest occurs.