Amniotic fluid embolism is very rare. It usually occurs during late pregnancy but may occur when an abortion is done during the 1st or 2nd trimester.
Risk factors
Many women are exposed to cells and tissues from the fetus during labor and delivery, and the conditions that increase risk are much more common than amniotic fluid embolism. Thus, it is unclear why amniotic fluid embolism develops in some women and not others.
Risk is increased when
Delivery is cesarean Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more
or forceps Operative Vaginal Delivery Operative vaginal delivery is delivery using a vacuum extractor or forceps. A vacuum extractor consists of a small cup made of a rubberlike material that is connected to a vacuum. It is inserted... read more are used.The woman is older.
The placenta detaches too soon (placental abruption Placental Abruption Placental abruption is the premature detachment of a normally positioned placenta from the wall of the uterus, usually after 20 weeks of pregnancy. Women may have vaginal bleeding and/or severe... read more ) or is in the wrong place (placenta previa Placenta Previa Placenta previa is attachment (implantation) of the placenta over the opening of the cervix, in the lower rather than the upper part of the uterus. Women may have painless, sometimes profuse... read more
).The woman has had an abdominal injury or a tear in the cervix.
Symptoms
The fluid or tissue can cause a serious reaction in the woman. The reaction usually occurs during or shortly after labor and delivery. The woman may have a rapid heart rate, an irregular heart rhythm, low blood pressure, and difficulty breathing. She may stop breathing (respiratory failure Respiratory Failure Respiratory failure is a condition in which the level of oxygen in the blood becomes dangerously low or the level of carbon dioxide in the blood becomes dangerously high. Conditions that block... read more ), or her heart may stop (cardiac arrest Cardiac Arrest and CPR Cardiac arrest is when the heart stops pumping blood and oxygen to the brain and other organs and tissues. Sometimes a person can be revived after cardiac arrest, particularly if treatment is... read more 
). About 20% of women with amniotic fluid embolism die.
Disseminated intravascular coagulation Disseminated Intravascular Coagulation (DIC) Disseminated intravascular coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets... read more is a common complication. In this disorder, small blood clots develop throughout the bloodstream, resulting in widespread bleeding with massive loss of blood. Emergency care is required.
Diagnosis
A doctor's evaluation
Prompt diagnosis and treatment of amniotic fluid embolism are essential.
Doctors diagnose amniotic fluid embolism based on symptoms, particularly when a woman has the following symptoms:
Sudden stopping of the heart
Sudden difficulty breathing
Low blood pressure
Widespread, uncontrolled bleeding
Treatment
Supportive care
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.
The baby may be delivered immediately using forceps or a vacuum extractor, or cesarean delivery may be done. Such a delivery does not appear to improve or worsen the woman's outcome. However, it may be lifesaving for the fetus if the fetus is old enough to survive outside the uterus.
