Amniotic fluid embolus: can we affect the outcome?

Abstract

Amniotic fluid embolism is a rare catastrophe unique to pregnancy. Its mortality rate remains high despite efforts at prompt and aggressive management protocols, highlighting the need to maintain a high index of suspicion. The intrusion of amniotic fluid into the maternal bloodstream may lead in certain women to a complex series of physiological reactions mimicking those seen in human anaphylaxis or sepsis, negating the purely embolic phenomenon theory as previously understood. The clinical picture is the sudden onset of cardiovascular collapse, cyanosis, haemorrhage or disseminated intravascular coagulopathy, during or soon after delivery. The mainstay of a successful outcome remains the identification of high-risk patients, as well as early clinical diagnosis and management.