Amniotic fluid embolism is a medical emergency, though rare in nature, can lead to fatality of the mother. This article will give an explanation regarding this mysterious disorder, along with the causes, treatment methods, and how it can be prevented.
Pregnancy is an important milestone in every woman’s life. Though pregnancy is one of the most blissful periods, it also comes with its share of problems, most of them common and curable, while some of them maybe risky to both the mother and child. One such debilitating and fatal disorder is amniotic fluid embolism, also known as AFE. This condition occurs when the amniotic fluid, which protects the fetus from shock, enters the blood stream and may play havoc to the maternal health.
Fetal hair, cells and some other debris, enter the bloodstream of the mother through the ruptured vein and can trigger a series of allergic reactions in the body. These reactions can lead to organ failure, which may eventually lead to death. One such complication is cardiorespiratory collapse, where the heart and lungs collapse.
Amniotic fluid embolism syndrome was first identified in the year 1941, when Lushbaugh and Steiner found fetal debris in the bloodstream of women who died while delivering a baby. Squamous cells of the fetus enter the venous system of the mother, leading to complexities and result in deterioration of health. There is no specific time for the occurrence of this syndrome as it may be seen during or after childbirth and also during abortion. The chances of survival are very bleak and even if a woman survives this disorder she may suffer from neurological impairment which is usually permanent.
Though there are no distinct causes for this obstetric emergency, some doctors believe that it may be caused when amniotic fluid may enter the veins of the uterine wall. However, there are also some other reasons which may lead to this obstetric complication,
- Trauma to the abdominal region as a result of a fall or blow.
- Amniocentesis, which is a medical procedure to check for the presence of any disabilities in the unborn fetus. This procedure involves removing a specific amount of amniotic fluid for examination.
- Ruptured membranes of the uterus.
- A rupture in the uterine or cervical vein may make it easier for the residual material of the fluid to mix with the blood.
- The difference in the blood pressure gradient of the uterus from the vein. An abnormal change in this gradient can cause the amniotic fluid and other debris to leak into the bloodstream.
Diagnosis is based on the laboratory observations, though there are no specific diagnostic tests. Blood tests, sonography and CT scans may be used to diagnose the exact condition. Once the diagnostic tests are done, the treatment may follow. Sadly there is no proper treatment yet and the condition may be diagnosed only during an autopsy.
However, if the patient survives this condition, then immediate cardiopulmonary resuscitation (CPR) is administered and the patient is placed on life support system to stabilize the condition. The health of the fetus and mother is also continuously monitored to note for any changes. In case, the mother cannot be resuscitated, then an emergency C-section delivery is performed.
There are several risk factors of this obstetric emergency. When complications arise it can prove harmful to the maternal and fetal health. Some of the risk factors that are associated with this fatal pregnancy complication are
- Troubled childbirth
- HELLP syndrome in pregnancy
- Placental abruption and previa
- Lacerations in the cervical wall
- Fetal distress
Unfortunately, the measures for prevention and predictability of this disorder are still unknown. A routine checkup with an obstetrician gynecologist will help monitor the presence of any abnormalities in the initial stages, so that severity can be prevented.