Amniotic Fluid Embolism

Subject: Midwifery II (Theory)

Overview

Amniotic fluid embolism occurs when amniotic fluid, debris, fetal squamous cell, mucus, vernix, or meconium is forced into maternal circulation via the uterus or placental site, forming an embolus that obstructs the pulmonary arteries or alveolar capillaries, causing varying degrees of respiratory distress and circulatory collapse. The body's reaction is divided into two stages. Signs and symptoms include the fast onset of mother respiratory distress, maternal hypotension, uterine hypertonia, convulsions that may occur just before the collapse, and blood coagulopathy that develops after the initial collapse, resulting in severe post-partum hemorrhage. Oxygen inhalation, suction, resuscitation, bleeding treatment, vital sign monitoring, and clotting factor infusion are all emergency treatments or management.

Amniotic fluid embolism is a condition that occurs when amniotic fluid, debris, fetal squamous cells, mucus, vernix, and meconium are forced into maternal circulation via the uterus or placental site, forming an embolus that obstructs the pulmonary arteries or alveolar capillaries, causing varying degrees of respiratory distress and circulatory collapse.

The body reacts in two stages. The first stage is characterized by pulmonary vasospasm, which results in hypoxia, hypotension, and cardiovascular collapse. The second phase is characterized by the development of left ventricular failure, bleeding, and coagulation problem, followed by pulmonary edema.

 Sign and Symptoms

  • The start of maternal respiratory distress was unexpected.
  • Uterine hypertonia and maternal hypotension
  • Cardiovascular collapse symptoms
  • Convulsions may occur soon before the collapse.
  • Following the initial collapse, blood coagulopathy develops, resulting in severe post-partum bleeding.

Diagnosis

  • Amniotic fluid was discovered in maternal blood.
  • Amniotic fluid is typically seen in the lungs after childbirth.
  • Fetal squamous cells are found in maternal sputum.

Management

  • Emergency treatment
  1. Treatment of respiratory distress and cardiovascular collapse includes
  2. Oxygen inhalation
  3. Suction
  4. Resuscitation
  5. Monitor fetal heart sound
  6. Treatment of hemorrhage
  7. Monitor vital signs (pulse, BP, respiration rate)
  8. If a mother has symptoms of DIC there should be an infusion of clotting factors
  9. Proper maintenance of blood pressure
  • Management of coagulopathy

​​​​​​​

References
Things to remember
  • Amniotic fluid embolism is a condition that occurs when amniotic fluid, debris, fetal squamous cells, mucus, vernix, and meconium are forced into maternal circulation via the uterus or placental site, forming an embolus that obstructs the pulmonary arteries or alveolar capillaries, causing varying degrees of respiratory distress and circulatory collapse.
  • The body reacts in two stages.
  • The first stage is characterized by pulmonary vasospasm, which results in hypoxia, hypotension, and cardiovascular collapse.
  • The second phase is characterized by the development of left ventricular failure, bleeding, and coagulation problem, followed by pulmonary edema.
  • Signs and symptoms include a fast start of maternal respiratory distress, hypotension, uterine hypertonia, convulsions that may occur just before the collapse, and blood coagulopathy that develops after the initial collapse, resulting in severe post-partum bleeding.
  • Emergency treatment or management includes oxygen inhalation, suction, resuscitation, bleeding treatment, vital sign monitoring, and clotting factor infusion if the mother has DIC symptoms.
Questions and Answers

Amniotic Fluid Embolism

This condition happens when amniotic fluid, debris, fetal squamous cells, mucus, vernix, or meconium is forced into the mother's bloodstream through the uterus or placenta, forming an embolus that blocks the pulmonary arteries or alveolar capillaries and causes varying degrees of respiratory distress and circulatory collapse.

Sign and Symptoms

  • Sudden start of respiratory discomfort in a pregnant woman.
  • Uterine hypertonia and maternal hypotension.
  • Cardiovascular collapse symptoms.
  • There may be convulsions right before the collapse.
  • After the initial collapse, blood coagulopathy sets in, leading to a severe postpartum hemorrhage.
  • Sudden start of respiratory discomfort in a pregnant woman.
  • Uterine hypertonia and maternal hypotension.
  • Cardiovascular collapse symptoms.
  • There may be convulsions right before the collapse.
  • After the initial collapse, blood coagulopathy sets in, leading to a severe postpartum hemorrhage.

Management

Emergency Treatment

  • Treatment of respiratory distress and cardiovascular collapse includes:
    • Oxygen inhalation,
    • Suction,
    • Resuscitation,
    • Monitor fetal heart sound,
    • Treatment of hemorrhage,
    • Monitor vital signs (pulse, BP, respiration rate),
    • If mother has symptoms of DIC there should be infusion of clotting factors.

© 2021 Saralmind. All Rights Reserved.