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Amniotic fluid embolism or anaphylactoid syndrome of pregnancy is a rare but life threatening condition that occurs when the amniotic fluid (the fluid that surrounds the fetus during pregnancy) or any fetal material enter the maternal bloodstream. This can occur during labor, a cesarean section, after abnormal vaginal delivery or during the second trimester of pregnancy. The syndrome may also occur 48 hours after delivery.
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The Process of Amniotic Fluid Embolism
The process on how the amniotic fluid embolism occurs is poorly understood, however, it is thought to occur in two phases. In phase 1, the amniotic fluid, fetal cells, hair or other material enters the blood stream of a pregnant woman. This creates a reaction that leads to the spasm of blood vessels in the lungs that result in interruption of normal blood supply to the heart and lungs. This will in turn lead to a lack supply of oxygen (hypoxia) that causes heart and lung damage. This will then result in heart failure and lung inflammation. When women survive this phase, they usually enter into phase 2. In phase 2, there is massive blood loss from the uterus and abnormal clotting of the blood. Both phases can lead to cardiac arrest and often death.
How Do You Know if a person has amniotic fluid embolism?
The usual signs of amniotic fluid embolism are acute shortness of breath, sometimes with a cough followed by a low blood pressure. Other symptoms of amniotic fluid embolism are fast, labored breathing, seizures, bluish discoloration of nails and mouth, bleeding (from the uterus) and change in mental status. This is an emergency situation and the victim / rescuer should contact emergency medical response immediately.
Who are at risk?
Amniotic fluid embolism is considered unpredictable and unpreventable event with unknown cause. This usually occurs after abnormal vaginal delivery and after delivery. In many studies almost 41% of women who had amniotic fluid embolism had a history of allergies. You may have an increased risk of developing the syndrome if:
- You have advanced maternal age
- You have more than one child (multiparity)
- You have Intense contractions during labor
- You have abdominal trauma, tears in the uterus or cervix or undergoing cesarean section
- An early separation of the placenta from the maternal wall occurs
- Fetal intestinal materials enter your bloodstream
- Fetal death or distress
Management of the condition
The treatment of Amniotic fluid embolism is usually supportive. In the event of cardiac arrest, CPR may be needed. If the woman does not respond to the resuscitation, an emergency cesarean section may be performed to save the baby.
Reference:
New South Wales Government. Intensive Care Coordination and Monitoring Unit. Amniotic Fluid Embolism. Retrieved on July 11, 2014 from http://intensivecare.hsnet.nsw.gov.au/amniotic-fluid-embolism