What You Should Know About Amniotic Fluid Embolism

pregnant woman is expecting to have her baby

Amniotic fluid embolism (AFE) is a very rare condition that affects the mother either right before or during childbirth. It is extremely dangerous and could be deadly. Although this complication impacts only 1 in 40,000 deliveries, doctors must be vigilant for the signs of AFE because they need to act immediately. There is not much time to save a mother’s life when she is affected by AFE.

AFE Is a Deadly Condition that Requires Intensive Treatment

This complication arises when amniotic fluid enters the mother’s circulatory system, and she has a severe reaction to it. This happens when there is some sort of breach between the uterus and circulatory system that allows the fluid to enter. Although it is common for amniotic fluid and other debris to enter the circulatory system, severe reactions are very rare. In most cases, this is harmless, and there are no health effects.

Although AFE is extremely uncommon, it accounts for 5-10% of maternal deaths during childbirth in the U.S. This is because the fatality rate for AFE is roughly 60%. Half of the women who suffer from the complication will die within the first hour. If the woman survives beyond the first hour, she is far from out of danger. Since there is no set treatment protocol, whether the mother survives often depends on the doctor’s skill and actions.

AFE has two phases to it. In the first phase, the mother will experience respiratory failure which can progress to cardiac arrest. Then, the woman will enter a hemorrhagic phase with uncontrolled bleeding. Making the problem worse, the mother will experience disseminated intravascular coagulopathy which prevents blood clotting. Any of these can kill the mother.

Physicians Don’t Have Much Time

Doctors must act extremely quickly when there are signs of AFE. However, it is difficult to make a quick diagnosis of the condition. Physicians often diagnose the problem after ruling practically everything else out. That causes them to lose valuable time in saving the mother’s life. Even quick and aggressive treatment may not be enough to save a life, but delayed treatment almost assures death.

There is no one set way to detect AFE as it is a diagnosis of exclusion. In some cases, doctors may not even diagnose the condition until after the mother’s death. Regardless, medical professionals must always remain vigilant during childbirth for any signs of complications because the mother’s condition can deteriorate in a hurry. Doctors are trained to recognize some early signs of AFE, but it is not generally the first thing that they would diagnose.

Even when a doctor has diagnosed AFE, there is no way to reverse or cure the condition. Instead, they must manage the symptoms and support the mother as they occur. In most cases, this means finding a way to control or stop the bleeding. This could happen through blood transfusions or even a hysterectomy. If the child has not yet been delivered, doctors should perform an immediate cesarean section. Researchers acknowledge that they still have much to learn about possible treatments.

AFE Could Cause Long-Term Health Effects

Women who survive AFE may still develop long-term complications because of the severe trauma. They could suffer from the following:

  • Mild to serious neurological complications
  • Heart damage
  • Memory loss
  • Organ failure
  • Hysterectomy

Babies may also be injured from AFE. They may suffer injuries such as cerebral palsy or hypoxic-ischemic encephalopathy. This condition could have severe effects on the short and long-term future of an entire family.

Researchers Are Still Learning About AFE

One of the major difficulties that doctors and researchers face in dealing with AFE is that so little is known about the condition. Even though it was discovered over a century ago, researchers are just beginning to learn more about this reaction. Researchers do not know what exactly causes AFE. They suggest some usual risk factors such as advanced age, many pregnancies, and uterine rupture could be responsible for AFE.

The lack of knowledge contributes in part to the condition’s deadliness. There is no set treatment protocol other than doing everything that they can to keep the mother alive and get her out of danger. Even without extensive knowledge about AFE, doctors should be able to spot signs of distress and must act to provide life-saving treatment.

Even though AFE is a very rare and deadly condition, doctors could still be legally responsible when women die from it. A failure to act quickly may be considered negligence. Although medical professionals cannot predict AFE or even prevent it, they can act quickly and vigilantly and monitor closely for any complications. A birth injury lawyer could review the facts of the case and advise whether there is a potential medical malpractice lawsuit against the doctor and hospital.


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