Amniotic fluid embolism: definition, symptoms, causes, treatment, etc.

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Definition

What is amniotic fluid embolism (amniotic fluid embolism)?

Amniotic fluid embolism, also known as amniotic fluid embolism, is a rare complication during childbirth.

Amniotic fluid embolism is a condition in which the amniotic fluid, fetal cells, hair, or anything else enters the mother's bloodstream through the placenta base of the uterus.

These various fluids and ingredients can trigger reactions that resemble allergies.

This reaction can then result in cardiorespiratory (heart and lung) collapse and excessive bleeding (coagulopathy).

Amniotic fluid embolism can actually occur during pregnancy.

However, this one labor complication occurs more frequently during labor or shortly thereafter.

Amniotic fluid embolism is a complication of childbirth that is quite difficult to diagnose.

If the doctor suspects you have this condition, action will be taken immediately to prevent complications for you and the baby that are life threatening.

In fact, amniotic fluid embolism is still one of the complications that can be fatal because it is difficult to predict and prevent.

Immediately bring pregnant women to give birth in the hospital instead of giving birth at home if they experience certain problems before birth.

Make sure all labor preparations and delivery equipment are ready to approach the D-day of birth.

The mother can be accompanied by a partner, other family members, or a doula if she is available to go to the hospital before giving birth.

How common is this condition?

Launching from the Cleveland Clinic, amniotic fluid embolism is a fairly rare condition.

This incidence occurs at 2-8 per 100,000 births and accounts for about 7.5-10% of maternal mortality.

There are several factors that can also increase your risk of developing amniotic fluid embolism.

These factors include having problems with the placenta, preeclampsia, excess amount of amniotic fluid (polyhydramnios), as well as being over 35 years of age during pregnancy and childbirth.

However, this can be overcome by reducing your risk factors. Talk to your doctor for more information.

Signs and Symptoms

What are the signs and symptoms of amniotic fluid embolism?

Amniotic fluid embolism is a condition that occurs suddenly and quickly.

The early stages of this complication usually include heart attack and rapid respiratory failure.

A heart attack occurs when the heart stops working and the mother loses consciousness and stops breathing.

Failure to breathe quickly occurs when the lungs can't supply enough oxygen for the blood or remove enough carbon dioxide from the blood.

This made it very difficult for the mother to breathe.

Other possible signs and symptoms of amniotic fluid embolism include the following:

• Sudden shortness of breath
• Excess fluid in the lungs (pulmonary edema)
• Sudden low blood pressure
• Sudden heart failure to pump blood effectively (cardiovascular collapse)
• Life-threatening blood clotting problems (disseminated intravascular coagulopathy)
• Changes in mental state such as anxiety
• Cold
• Fast heart rhythm or disturbances in heart rhythm
• Fetal distress, such as a slow heart rhythm
• Seizures
• Coma
• Sudden fetal heart rhythm abnormalities
• Bleeding from the uterus, incision, or intravenous (IV) location

Make sure to go to the hospital immediately when signs of childbirth appear.

Signs of going into labor usually include ruptured water, labor contractions, and the opening of the delivery.

However, distinguish the symptoms of the original labor contractions with the false contractions that often get confused in the third trimester of pregnancy.

When to see a doctor?

If you experience any of the signs or symptoms listed above related to amniotic fluid embolism or have any questions, you should consult your doctor immediately.

Everyone's body reacts differently.

It is best to discuss with your doctor what is best for your situation.

Cause

What causes amniotic fluid embolism?

Amniotic fluid embolism is a complication that can occur during labor and after the birth process is over.

This condition can be experienced by those of you who gave birth normally through the vagina in any labor position or had a cesarean section.

Amniotic fluid embolism is a complication that occurs when amniotic fluid or parts of the fetus enter the mother's bloodstream.

The cause of the occurrence of amniotic fluid embolism is not well understood.

The most likely cause of amniotic fluid embolism is damage to the placental barrier such as trauma or injury.

When this damage occurs, the immune system responds by doing various things.

The body's response ranges from releasing a substance that causes an inflammatory reaction (inflammation) to activating abnormal clots in the lungs and blood vessels of the mother.

All of these can lead to a serious blood clotting disorder known as disseminated intravascular coagulation.

However, amniotic fluid embolism is a rare thing.

This is because having some of the amniotic fluid entering the mother's bloodstream during labor does not always cause problems.

It is not clear why in some cases this is the cause of amniotic fluid embolism.

For more details, further research is needed on the causes of this amniotic fluid embolism.

Risk Factors

What puts a person at risk for amniotic fluid embolism?

Amniotic fluid embolism is actually very rare during childbirth.

That's why it's quite difficult to identify risk factors for amniotic fluid embolism, according to the Mayo Clinic.

However, several factors can increase the risk of amniotic fluid embolism.

Some of the risk factors that can trigger a person to develop amniotic fluid include:

1. Old age at pregnancy

If you were 35 years or older at birth, your risk of developing amniotic fluid embolism increases.

The older you are at pregnancy and childbirth, the greater the risk of developing this complication.

2. Placenta problems

If there is an abnormality in your placenta, your risk of developing amniotic fluid embolism increases.

Abnormalities in the structures that develop in the uterus during pregnancy, for example, can increase the risk of these complications.

The presence of placental abnormalities includes part or all of the placenta covering the cervix (placenta previa).

The condition of the placenta that peels from the inner wall of the uterus before delivery (placental abruption) also increases the risk.

Both of these conditions can cause problems with the placenta or protector of the baby while in the womb.

3. Preeclampsia

Be careful, if you have preeclampsia, which is high blood pressure and excess protein in the urine after 20 weeks of pregnancy.

The reason is, these various conditions can put you at a higher risk of experiencing amniotic fluid embolism.

4. Medically triggered births

The method of labor induction given before delivery is thought to increase the risk of experiencing amniotic fluid embolism.

However, further research is needed to ensure this is clear.

5. Childbirth by caesarean section

Having a cesarean section, giving birth with forceps, or vacuum extraction can increase the risk of amniotic fluid embolism.

This is because using these tools can destroy the physical barrier between you and your baby, aka the amniotic sac.

However, it is unclear whether surgical delivery is indeed a risk factor for amniotic fluid embolism.

The reason is, the use of forceps and vacuum is actually intended to speed up births in normal delivery, especially if the doctor has suspected amniotic fluid embolism.

6. Polyhydramnios

Polyhydramnios is a condition when the amount of amniotic fluid in the baby is too much.

This is a type of amniotic fluid (hydramnios) disorder.

Having too much fluid surrounding the baby in the womb can put you at risk for amniotic fluid embolism.

Other risk factors for amniotic fluid embolism

In addition to the various risk factors mentioned above, amniotic fluid embolism can also be triggered by the following:

• Are pregnant with twins, triplets, or more
• The baby has fetal distress, or lack of oxygen supply during pregnancy and delivery
• Placental disorders
• Eclampsia, which is a more severe form of complication than preeclampsia
• Uterine rupture or uterine tear
• Fast labor

The various risk factors described previously do not always result in amniotic fluid embolism.

However, having one or more of these risk factors can increase your chances of having an amniotic fluid embolism.

The doctor will immediately provide the appropriate treatment, if the mother has one or more of the risk factors above which are accompanied by certain medical complaints.

Diagnosis and Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

How to diagnose this condition?

The diagnosis of amniotic fluid embolism is determined based on a doctor's examination. The diagnosis is usually made after other conditions have been eliminated.

In some cases, the diagnosis can be made only after the death of the mother.

Several tests will be done to diagnose amniotic fluid embolism, including:

• Blood tests, including those that evaluate clotting, heart enzymes, electrolytes and blood types, and complete blood count (CBC).
• An electrocardiogram (ECG or EKG) to evaluate your heart rhythm.
• Pulse oximetry to check the amount of oxygen in your blood.
• Chest X-ray to check the fluid around your heart.
• Echocardiography (ECG) to evaluate your heart function.

What are the treatments for amniotic fluid embolism?

The condition of amniotic fluid embolism requires immediate treatment in order to overcome the depleted oxygen supply and low blood pressure.

Doctors and the medical team can provide individual care for you and the baby that is being born.

Handling for mothers

The treatment given to the mother aims to prevent the severity of the symptoms from leading to coma and even death.

The doctor will provide additional oxygen or an oxygen ventilator to make sure you are getting enough oxygen.

This is important because it means the supply of oxygen for the baby is also adequate.

The rest, the doctor can insert a catheter to check the condition of the heart and give drugs to control blood pressure.

In some cases, blood transfusions may also be done to replace blood lost during bleeding during childbirth.

Handling for babies

During the delivery process, the doctor and medical team will always monitor the baby's condition.

Usually, a new baby will be born after your body's condition is deemed stable enough.

That way, this can increase the baby's chances of survival.

But after that, babies usually have to be treated intensively by doctors and the medical team in special baby wards.

In particular, here are various emergency treatments that can be given for amniotic fluid embolism:

1. Using a catheter

Your medical team will place a thin, hollow tube into one of the arteries (arterial catheters) to monitor your blood pressure.

Another tube will also be placed into a vein in your chest (central venous catheter) which can be used to give fluids, drugs or transfusions, and draw blood.

2. Giving oxygen

You will probably need a breathing tube that is inserted into your airway to help you breathe.

3. Administration of drugs

Your doctor may order drugs to improve and support your heart function.

Other medicines can be used to lower the pressure caused by fluid getting into your heart and lungs.

4. Provide blood transfusions

If you experience uncontrolled bleeding, you will need blood transfusions, blood products, and fluid replacement.

If you experience an amniotic fluid embolism before giving birth, the doctor will provide medication so that the baby can be delivered safely.

Emergency caesarean section may be required.

Prevention

What can I do at home to prevent or treat this condition?

Amniotic fluid embolism cannot be prevented. The cause of pregnancy complications due to amniotic fluid embolism also tends to be difficult to predict when it will occur.

If you have experienced amniotic fluid embolism and are planning to try to get pregnant again, you should consult your obstetrician first.

Your doctor will previously check your medical history and current body condition to help determine the best option for you.

If you have any questions, consult your doctor to better understand the best solution for you.