Amniotic Fluid Embolism

Amniotic fluid embolism (abbreviated to AFE) is a rare complication of childbirth wherein amniotic fluid enters the mother’s blood stream, triggering an allergic reaction.

Causes

AFE is a poorly-understood disease. It is generally agreed, however, that the movement of amniotic fluid into the bloodstream requires a rupture in both the amniotic sac membrane, and the veins in the uterus.

Disease pathway

The condition is so rare that most doctors will never encounter it. For this reason, the exact mechanism of the disease is not well known.

Initially, the patient experiences shortness of breath and abnormally low blood pressure, as blood fails to circulate properly, resulting in decreased oxygen supply to the heart and lungs. The patient is likely to lapse in a coma, with an approximately 50 per cent likelihood of survival.

Those who survive the first phase of the condition will enter the hemorrhagic phase, which is characterized by:

·         Shivering;

·         Coughing; and

·         Vomiting.

Meanwhile, dilution of the blood causes the loss of its ability to clot. Severe bleeding follows, and may cause fetal distress and death.

Treatment

AFE must be diagnosed and treated immediately to increase the likelihood of the mother and foetus’ survival.

The mother may be given a blood transfusion, and drugs may be administered to promote contraction of the heart.

An immediate caesarian section is usually performed.