Overview

Amniotic fluid embolism may be a rare but serious condition that happens when amnionic fluid — the fluid that surrounds a baby within the uterus during pregnancy — or fetal material, such as fetal cells, enters the mother's bloodstream. Amniotic fluid embolism is presumably to occur during delivery or within the immediate postpartum period.

Amniotic fluid embolism is difficult to diagnose. If your doctor suspects you would possibly have one, you will need immediate treatment to stop potentially life-threatening complications.

Symptoms

Amniotic fluid embolism might develop suddenly and rapidly. Signs and symptoms might include:

Ø  Sudden shortness of breath

Ø  Excess fluid in the lungs (pulmonary edema)

Ø  Sudden low blood pressure

Ø  Sudden failure of the heart to effectively pump blood (cardiovascular collapse)

Ø  Life-threatening problems with blood clotting (disseminated intravascular coagulopathy)

Ø  Bleeding from the uterus, cesarean incision or intravenous (IV) sites

Ø  Altered mental status, such as anxiety or a sense of doom

Ø  Chills

Ø  Rapid heart rate or disturbances in the rhythm of the heart rate

Ø  Fetal distress, such as a slow heart rate, or other fetal heart rate abnormalitie

Ø  Seizures

Ø  Loss of consciousness

Causes

Amniotic fluid embolism occurs when amnionic fluid or fetal material enters the mother's bloodstream. A likely cause may be a breakdown within the placental barrier, like from trauma.

When this breakdown happens, the system responds by releasing products that cause an inflammatory reaction, which activates abnormal clotting within the mother's lungs and blood vessels. This can result in a serious blood-clotting disorder known as disseminated intravascular coagulation.

However, amnionic fluid embolisms are rare — and it's likely that some amnionic fluid commonly enters the mother's bloodstream during delivery without causing problems. It's not clear why in some mothers this results in amnionic fluid embolism.

Risk factors

It's estimated that there are between one and 12 cases of amnionic fluid embolism for each 100,000 deliveries. Because amnionic fluid embolisms are rare, it's difficult to spot risk factors.

Research suggests that several factors could be linked to an increased risk of amnionic fluid embolism, however, including:

Ø     Advanced maternal age. If you're 35 or older at the time of your child's birth, you would possibly be at increased risk of amnionic fluid embolism.

Ø     Placenta problems. Abnormalities within the placenta — the structure that develops in your uterus during pregnancy — might increase your risk of amnionic fluid embolism. Abnormalities might include the placenta partially or totally covering the cervix (placenta previa) or the placenta peeling faraway from the inner wall of the uterus before delivery (placental abruption). These conditions can disrupt the physical barriers between you and your baby.

Ø     Preeclampsia. Having high blood pressure and excess protein in your urine after 20 weeks of pregnancy (preeclampsia) can increase your risk.

Ø     Medically induced labor. Limited research suggests that certain labor induction methods are related to an increased risk of amnionic fluid embolism. Research on this link, however, is conflicting.

Ø     Operative delivery. Having a C-section, a delivery or a vacuum extraction might increase your risk of amnionic fluid embolism. These procedures can disrupt the physical barriers between you and your baby. It's not clear, however, whether operative deliveries are true risk factors for amnionic fluid embolism because they're used after the condition develops to make sure a rapid delivery.

Ø     Polyhydramnios. Having an excessive amount of amnionic fluid around your baby may put you in danger of amnionic fluid embolism.

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