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Amniotic Fluid Embolism

By Julie S. Moldenhauer, MD

Amniotic fluid embolism occurs when some amniotic fluid—the fluid that surrounds the fetus in the uterus—enters the woman’s bloodstream, usually during a particularly difficult labor.

Amniotic fluid embolism is very rare. Risk is increased when

  • Delivery is cesarean or forceps are used.

  • The woman is older.

  • More than one fetus is present.

  • The placenta detaches too soon (placental abruption) or is in the wrong place (placenta previa).

  • The woman has had an abdominal injury.

The fluid can cause a serious reaction in the woman. She may have a rapid heart rate and an irregular heart rhythm. She may collapse or go into shock or even cardiac arrest. About 13 to 44% of women with amniotic fluid embolism die. Widespread blood clotting (disseminated intravascular coagulation), sometimes also with bleeding, is a common complication, requiring emergency care (see Disseminated Intravascular Coagulation (DIC)).

Prompt diagnosis and treatment are essential. Doctors diagnose this problem based on symptoms.

Women may be given a transfusion of blood and blood components. Injection of a blood clotting factor (which helps blood clot) may be lifesaving. Women may require assistance with breathing or drugs to help the heart contract.