Amniotic fluid embolism is a rare but serious condition that occurs during pregnancy when fetal materials such as the fluid surrounding the baby in the uterus or fetal cells enter the mother’s bloodstream. It is likely to occur during childbirth or in the postpartum period.
Diagnosis of amniotic fluid embolism is difficult. If your doctor suspects it, you will need prompt treatment to prevent life-threatening complications.
Amniotic Fluid Embolism Symptoms
Amniotic fluid embolism can develop suddenly and rapidly. Signs and symptoms may include:
Sudden shortness of breath
Excess fluid in the lungs (pulmonary edema)
Sudden low blood pressure
Inability of the heart to pump blood effectively (cardiovascular collapse)
Life-threatening problems with blood clots (disseminated intravascular coagulation)
Bleeding from the uterus, cesarean section incision, or intravenous (IV) sites
Changes in mental state, such as feelings of anxiety or worry
Rapid heart rate or disturbances in the rhythm of the heart rate
Fetal distress, such as a slow heart rate or other fetal heart rate abnormalities
Loss of consciousness
Causes of Amniotic Fluid Embolism
An amniotic fluid embolism occurs when amniotic fluid or fetal material enters the mother’s bloodstream. A possible cause is a disruption in the placental barrier, such as trauma.
When this malfunction occurs, the immune system responds by releasing substances that cause an inflammatory reaction that activates abnormal clotting in the mother’s lungs and blood vessels. This can cause a serious blood clotting disorder known as disseminated intravascular coagulation.
However, amniotic fluid embolisms are rare, and it is likely that some amniotic fluid will enter the mother’s bloodstream during childbirth without causing problems, usually. It is not clear why it causes amniotic fluid embolism in some mothers.
How Is Amniotic Fluid Embolism Diagnosed?
The diagnosis of amniotic fluid embolism is typically made after other conditions have been ruled out.
During your evaluation, your healthcare provider may order the following laboratory tests:
Blood tests, including those that evaluate clotting, heart enzymes, electrolytes, blood type, and complete blood count (CBC)
Electrocardiogram (ECG) to evaluate your heart’s rhythm
Pulse oximetry to check the amount of oxygen in your blood
Chest X-ray to look for fluid around your heart
Echocardiography to evaluate your heart’s function
Amniotic Fluid Embolism Treatment
Amniotic fluid embolism requires prompt treatment to resolve low blood oxygen and low blood pressure.
Emergency treatments may include:
Catheter placement: A thin, hollow tube inserted into one of your arteries (arterial catheter) may be used to monitor your blood pressure. You may also have another tube inserted into a vein in your chest (central venous catheter) that can be used to give fluids, medication, or transfusions and draw blood.
Oxygen: You may need to wear a respirator in your airway to help you breathe.
Medications: Your doctor may give you medication to improve and support your heart function. Other medications may also be used to reduce the pressure caused by fluid entering your heart and lungs.
Transfusion: If you have uncontrollable bleeding, you will need a transfusion of blood, blood products, and replacement fluids.
If you have an amniotic fluid embolism, your doctor will treat your baby with the goal of safely delivering it to you as soon as possible.