Intravascular invasion of amniotic fluid into the maternal circulation can cause pulmonary embolism by blocking blood vessels in the lungs, triggering vasoconstriction and coagulation. Known as amniotic fluid embolism (AFE), it is usually fatal and a leading cause of maternal death. AFE symptoms include sudden respiratory distress, cyanosis, cardiorespiratory arrest and hemorrhaging in a woman late in labor or immediately after childbirth, often causing sudden death. Diagnosis is usually made postmortem by finding fetal debris in the lungs, though this test is not very sensitive. Management focuses on oxygenation, ventilation, steroids and coagulation support.

1. DR.PRIYA SAXENA

2.  Intravascular invasion of the maternal circulation by amniotic fluid and its
content can block the pulmonary vasculature causing
 vasoconstriction and
 triggering of coagulation system.
 It is usually fatal and is considered an inevitable cause of maternal
mortality.

3. SYMPTOMATOLOGY
 The clinical features are due to two components:
 Embolism: causing acute respiratory distress or even death
 Coagulation failure: causes hemorrhage
 Typically a woman in late labor or immediate postpartum:
 gasps for air,
 has severe bronchoconstriction,
 becomes cyanotic and
 undergoes immediate collapse and cardiorespiratory arrest, usually
accompanied by hemorrhage.
 Sudden death is usual.
 The diagnosis is usually made on postmortem examination when fetal
debris can be demonstrated in the pulmonary vasculature but it is not very
sensitive and specific

4. ONSET
 After amniotomy and at cesarean section
 In labor, with strong uterine contractions
 Immediate postpartum period

5. MANAGEMENT
 Maintenance of perfusion
 Endotracheal intubation and mechanical ventilation with 100% oxygen
 Hydrocortisone IV in large doses
 Aminophylline IV for respiratory distress
 Correction of specific coagulation defects with fresh blood, fresh frozen
plasma, platelets and cryoprecipitate.

6. THANK YOU