This topic contains definition, mechanism, risk factors, sign and symptoms, diagnosis, treatment and complications of amniotic fluid embolism.

1. BY, MS.PRIYANKA GOHIL
M.Sc. (N) OBG,
PhD Scholar in Nursing

2. “Amniotic fluid embolism is the eascape
of amniotic fluid into the maternal
circulation. This condition is usually fatal
to the mother as the debris-containing
amniotic fluid deposits in the pulmonary
arterioles.”

4. Liqour amnii is forced into the maternal
circulation either through a rent in the
membranes or placenta.
Thromboplastin rich liqour amnii
containing the debris, blocks the
pulmonary arteries and triggers the
complex coagulation mechanism
leading to DIC.
There is massive fibrin deposition
destriuted throughout the entire
pulmonary vascular tree.

5. If the patient survives from the severe
cardiopulmonary embarrassment which
stimulates thromboembolic
phenomenon, there will be severe
clotting defect with profuse bleeding per
vaginam or through the veno-puncture
sites due to consumption of coagulation
factors.

6. From the damaged endothelium of the
pulmonary arteries, massive fibrinolytic
activators are produced which excite the
fibrinolytic system converting the
plasminogen to plasmin which in turn
produces lysis of firin, fibrinogen and
even the factor V and VIII.
Thus, there is secondary fibrinolysis on
the top of primary fibrinogen arising out
of DIC.

8. 1. Advanced maternal age
2. Placental problems
3. Preeclampsia
4. Medically induced labour
5. Operative delivery
6. Polyhydramnios

9. 1. Abrupt onset of respiratory distress
2. Chest pain
3. Cyanosis
4. Seizures
5. Heart failure
6. Pulmonary edema
7. Fetal bradycardia
8. Fetal distress, if delivery had not yet
occured.

10. Blood tests, including those that
evaluate clotting, heart enzymes,
electrolytes and blood type, as well as a
complete blood count (CBC)
Electrocardiogram (ECG)
Pulse oxymetry
Chest x-ray
Echocardiography

11. Immediately, start the emergency/
resuscitative measures to maintain the
life of the patient.
Administer oxygen at 8 to 10 L/min by
face mask or resuscitation bag, so as to
deliver 100% oxygen.
Prepare the patient for intubation and
mechanical ventilation.
Give het side-lying position.

12. Start I/V fluids, blood products and
medications to correct coagulation
failure.
Check the status of the fetus.
When the condition of the mother
stabilizes, prepare for an emergency
delivery.
Reassure the mother and provide
emotional support to her family.

13. 1. Brain injury
2. Maternal death
3. Infant death