Amniotic Fluid Embolism

Rare but severe complication of pregnancy in which amniotic fluid enters maternal circulation

Aetiology

  • The cause of this phenomenon is still under debate however possible roles have been attributed to strong uterine contractions, excessive amniotic fluid and disruption of vessels supplying the uterus
  • Not predictable or preventable, usually occurs in labour

Clinical presentation

Sudden onset of:
  • Hypoxia/respiratory arrest
  • Hypotension
  • Fetal distress
  • Seizures
  • Shock
  • Confusion
  • Cardiac arrest
  • Disseminated intravascular coagulation

Investigations

  • Bloods - FBC, U&E, calcium and magnesium, clotting studies, ABG
  • ECG - ischaemic changes
  • Chest x-ray - shows pulmonary oedema

Management

  • Supportive - ABCDE approach