Amniotic fluid embolism

The fetus will respond to the changes in the mother if still in labor by exhibiting tachycardia and decelerations in the fetal heart rate tracing.

It will then register as a low pulse oximetry reading when performed by the health care staff and will result in hypoxia.

[5] Most commonly patients will experience hypotension or low blood pressure due to the widespread inflammation and anaphylaxis occurring.

[4] As the amniotic fluid embolism progresses the final stage before cardiovascular collapse involves hemorrhaging or large volume blood loss.

[5][7] It is also supposed that endothelin a potent vasoconstrictor is upregulated during the course of the amniotic fluid embolism in the maternal circulation.

[5] This leads to super tight vessels that cut off the blood supply to the lungs and heart resulting in cardiorespiratory collapse.

[4] Induction with vaginal prostaglandin E2 was seen as significantly increasing the relative risk for the emergence of amniotic fluid embolism on a laboring mother.

[8][6] A patient at risk of cardiovascular compromise due to late stage vasodilation of the blood vessels should be given phenylephrine to vasoconstrict the arteries and raise the blood pressure to prevent persistent hypotension[8] Due to the nature of AFE being an anaphylaxis like reaction epinephrine should be given as well.

[8] A case report on Amniotic Fluid Embolism published in the A & A Practice Journal in 2020 has revealed that when milrinone is administered as an aerosol, selective pulmonary vasodilation occurs without significant changes[9] in mean arterial pressure or systemic vascular resistance; and if used immediately after Amniotic Fluid Embolism, inhaled milrinone may mitigate the pulmonary vasoconstriction.

[12][13] A 1941 case study of eight autopsies of pregnant women who died suddenly during childbirth by Clarence Lushbaugh and Paul Steiner enabled widespread recognition of the diagnosis within the medical community, and was eventually republished as a landmark paper in the Journal of the American Medical Association.

Pathophysiology of the amniotic fluid embolism