What is an Amniotic Fluid Embolism?

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An amniotic fluid embolism, or AFE, is a very rare occurrence that most doctors aren’t familiar with. In fact, the exact process isn’t even understood, although it’s believed that it occurs when fetal cells and fluid enter the mother’s pulmonary circulation. Many first-time mothers reading about pregnancy complications wonder, what is an amniotic fluid embolism exactly and am I at risk? Fortunately, exposure to fetal tissue and fluid is common and very few women have any kind of reaction. Here’s what an AFE is and what happens.

What is an Amniotic Fluid Embolism?
An amniotic fluid embolism is a serious obstetric emergency in which hair, amniotic fluid, fetal cells or other debris enter the mother’s blood stream through the placenta and trigger an allergic reaction. This allergic reaction can be serious enough to cause lung and heart collapse. Some statistics show that up to 50% of patients with AFE die within an hour of symptoms and many who do survive suffer from permanent neurological damage. The condition seems to result most commonly from amniotic fluid entering uterine veins and requires a pressure gradient from the uterus to the vein, a ruptured cervical or uterine vein and ruptured membranes.

What is an Amniotic Fluid Embolism: The Stages
An AFE occurs in two stages. During the first, the mother will experience hypertension and extreme shortness of breath. This will quickly turn into cardiopulmonary (heart and lung) arrest as the heart stops dilating and the lungs fail to receive oxygen. Most women with AFE do not survive past the first stage. Those who do will enter the hemorrhagic phase, which comes with vomiting, coughing, extreme shivering and a strange taste in the mouth, plus excessive bleeding.