Amniotic fluid embolism can be a devastating syndrome with disseminated intravascular coagulation, respiratory failure, circulatory collapse and sudden death. Prompt recognition and aggressive therapy can be lifesaving.
Risk factors for amniotic fluid embolism:
(1) older age
(2) multiparity
(3) intense uterine contractions, either physiologic or drug induced
(4) abdominal trauma
(5) cesarean section
(6) uterine rupture
(7) high cervical tear
(8) premature placental separation
(9) placental abruption
(10) intrauterine fetal demise or fetal distress
Most cases (80%) occur during labor, but it can occur either before labor or after delivery. About 25% of patients will die within 1 hour of onset.
The diagnosis of amniotic fluid embolism should be considered when a pregnant woman with one or more of these risk factors suddenly deteriorates with respiratory distress, bleeding or shock.
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