Amniotic Fluid Embolism (AFE)

Definition - What does Amniotic Fluid Embolism (AFE) mean?

An amniotic fluid embolism (AFE) is a pregnancy-related complication where amniotic fluid (present in the amniotic sac) enters the mother’s blood. Later, fetal antigens enter the mother's blood and trigger a serious allergic reaction affecting the lungs and heart. Although the condition is rare, it is the leading cause of death during labor or just after birth. AFE is quite similar to the life-threatening allergic reaction called anaphylaxis.

Amniotic fluid embolism is also referred to as anaphylactoid syndrome of pregnancy.

FertilitySmarts explains Amniotic Fluid Embolism (AFE)

The exact cause of AFE is unknown. However, it is believed that the following factors may trigger AFE:

  • Allergies
  • Having multiple children
  • Advanced age
  • Procedures such as amniocentesis, cesarean section or operative vaginal delivery, and dilation and curettage (D&C)
  • Trauma
  • Low-lying placenta (placenta previa)
  • Having too much fluid in the amniotic sac (polyhydramnios)
  • Premature separation of the placenta (placental abruption)
  • Kidney disease
  • Heart disease

AFE is the result of the transfer of fetal antigens into the mother's blood, causing sudden difficulty breathing and low blood pressure. The baby’s movements also become slow due to insufficient oxygen. If not addressed immediately, the woman is likely to develop profuse bleeding requiring transfusion of blood products due to widespread activation of the clotting cascade. The woman may lose consciousness and pass out. The amniotic fluid can be aspirated into the lungs and reach the heart leading to failure of these organs. In more severe cases, the woman develops organ failure followed by cardiac arrest and/or fits, shock, and death.

Treatment is mainly supportive and requires admission to an intensive care unit. Because the factors that trigger AFE cannot be prevented, treatment to address the symptoms may help. If the mother is unresponsive to resuscitation, emergent cesarean delivery will be needed.

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