Amniotic Fluid Embolism: Know the signs

Woman Survives one of the Most Feared Complication of Childbirth at Aster Hospital.

Critical Care Medicine Specialists & the team of Gynecologists at Aster Hospital Mankhool ensured the miraculous recovery of the mother and baby.

  • Amniotic fluid embolism (AFE) is one of the most catastrophic complications of pregnancy
  • Such cases are extremely rare with an incidence of 2-8 per 100,000 deliveries
  • The maternal prognosis after amniotic fluid embolism is very poor with an infant survival rate of around 70% (i)

In an exceptional medical case, a 34-year-old Filipino woman and her baby had a miraculous recovery at Aster Hospital Mankhool, after almost succumbing to a very rare complication called ‘Amniotic Fluid Embolism’ during the delivery.

Amniotic Fluid Embolism (AFE) is a life threatening condition that may occur during labor, caesarean section, or immediately after delivery. In this condition, the amniotic fluid that surrounds the baby in the uterus, containing fetal cells, hair particles and other fetal material enters the mother’s bloodstream.

A 34 year old pregnant woman, suffering from hypertension came to Aster hospital for her pregnancy check-up. She was admitted for induction of labor in view of 37 weeks pregnancy with hypertension. She had spontaneous rupture of the water bag followed by which she developed breathing difficulty and fits. Recognizing the symptoms, the gynecologist suspected the onset of AFE, and found that the unborn baby had a very low heart rate. An emergency C-section was performed to deliver the baby, further to which the baby was taken to the NICU and intubated.

During the surgery, the patient suffered from Hypotension (low BP), cardiac arrest, disseminated intravascular coagulation (DIC), a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels, and hemorrhage requiring massive blood transfusion. One of the major difficulties in the initial treatment of amniotic fluid embolism is the rapidity at which signs and symptoms can progress in the patient, with fast deterioration of health.

“Amniotic Fluid Embolism is a rare yet known complication of pregnancy that has variable presentations. It could be caused when the amniotic membrane breaks allowing the amniotic fluid to enter the bloodstream, although there is no established cause or prevention technique. AFE can be extremely fatal to the mother and the child with devastating consequences. Complications include; respiratory issues, multiple organ dysfunction, massive blood loss and disseminated intravascular coagulation (DIC) leading to cardiac arrest,” said Dr. Sejal Devendra Surti, Specialist Gynecologist, Aster Hospital Mankhool.

“This was one of the most challenging cases that we have managed in the recent times. During the emergency C-section, the mother suddenly suffered a heart attack, and had continuous bleeding because of DIC. Massive blood transfusion was started with medicines to improve her blood pressure.

The patient finally got her pulse back and was monitored for 2 hours. But soon after, the bleeding increased again. The patient also developed respiratory failure for which she was kept on mechanical ventilator (artificial breathing). She suffered from multiple complications during her time in the Operation Theater including 2 episodes of cardiac arrest.” said Dr. Alai Taggu, Specialist Physician and H.O.D Critical Care Medicine, Aster Hospital Mankhool.

After the near fatal experience, the patient was extubated after 3 days when she made a full recovery after the unified efforts of the team of Gynecologists, Critical Care team and the Anesthetists in the Operation Theater. She was discharged on the fourth day after her delivery.

Since there are no tests that can be done to diagnose the condition, a few symptoms that should be kept in mind are; nausea, skin discoloration, seizure, anxiety, poor fetal heartrate, sudden drop in blood pressure and poor oxygen levels in the blood. However, these are not diagnostic symptoms and could be caused as a result of other pregnancy related conditions. It is extremely important for the condition to be notice and picked up at the earliest in order to ensure successful management.

Dr. Sejal Devendra Surti 

Specialist Obstetrician & Gynaecologist 

Dr. Alai Taggu

Specialist Physician and HOD of Critical Care Medicine 

Aster Hospital Mankhool

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