More recent theories suggest that AFE is an immune mediated response to the presence of amniotic fluid in the maternal circulation. Initially AFE was thought to be secondary to the mechanical obstruction of the maternal circulation by amniotic fluid. It is also associated with significant morbidity of surviving mothers and their babies. AFE has emerged as one of the leading causes of direct maternal death within developed countries such as Australia, the UK and the USA. However non-classical presentations may also occur and the clinician must always consider the possibility of AFE when dealing with an unwell obstetric patient.Īlthough AFE was first identified as a clinical entity in 1941 it remains an unpredictable condition and treatment is still largely supportive. AFE classically presents as a sudden cardiovascular collapse associated with respiratory compromise, fetal distress and the development of a coagulopathy. It most commonly presents in the intra-partum or immediate post-partum period. INTRODUCTIONĪmniotic Fluid Embolism (AFE) is a rare but potentially fatal syndrome that is unique to pregnancy. The neonate suffered from meconium aspiration syndrome but both the mother and baby survived with no long term medical issues. She was extubated on the second ICU day and discharged from ICU on the fourth day. After treatment measures were instituted for the pulmonary hypertension she made a rapid recovery. Echocardiography revealed severe right ventricular failure with elevated pulmonary artery pressures. The mother deteriorated further in the ICU, requiring large doses of vasopressor and inotropic therapy in addition to further blood products to correct her coagulopathy.
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