The risk of amniotic fluid embolism

In fact, the probability of amniotic fluid embolism is still relatively high. Generally speaking, it is a symptom that only appears during the delivery process. At this time, acute embolism will occur. If it is not well relieved, it will cause pregnant women to have symptoms of shock. This is more dangerous. It will not only affect the normal delivery of the fetus, but also directly endanger the life safety of pregnant women.

Amniotic fluid embolism refers to a serious complication during delivery in which amniotic fluid suddenly enters the maternal blood circulation, causing acute pulmonary embolism, anaphylactic shock, disseminated intravascular coagulation, renal failure or sudden death. The incidence rate is 4/100,000 to 6/100,000. Amniotic fluid embolism is caused by the entry of tangible substances (fetal vellus, keratinized epithelium, vernix caseosa, meconium) and procoagulant substances in the contaminated amniotic fluid into the maternal blood circulation.

Studies have shown that amniotic fluid embolism is mainly an allergic reaction. After the amniotic fluid enters the maternal circulation, it causes a series of allergic reactions in the mother to fetal antigens. Therefore, it is recommended to name it "pregnancy allergic reaction syndrome." Amniotic fluid embolism has a very low incidence rate, but once it occurs the mortality rate is extremely high. [1]

Amniotic fluid embolism refers to a syndrome in which, during delivery, the contents of amniotic fluid, such as vernix caseosa, keratinized epithelial cells, meconium, and vellus hair, enter the maternal blood circulation, forming emboli that block the pulmonary blood vessels, leading to a series of serious symptoms such as maternal shock, hemorrhage, and disseminated intravascular coagulation (DIC). The onset is acute, the condition is severe, and the mortality rate is high. The cause of the disease is mostly excessive or rigid uterine contraction, high intrauterine pressure, and rupture of the fetal membranes or shortly after rupture, when amniotic fluid enters the maternal blood circulation through the lacerated endocervical veins.

If unexplained dyspnea, cyanosis, shock, uterine bleeding, etc. suddenly occur during delivery, this disease should be suspected. Treatment includes anti-allergic, oxygen supply, relief of pulmonary hypertension, blood volume replenishment, anti-shock, correction of DIC, etc. If the fetus has not been delivered, delivery should be ended immediately. Amniotic fluid embolism has an acute onset and a severe course, with most patients dying within a short period of time after onset. Avoiding inducing factors, timely diagnosis, and organizing rescue and treatment as soon as possible are the keys to survival.

1. Shock and hypoxemia: Mild: Transient symptoms may occur during oxytocin drip: chest tightness, chills, cyanosis, and a sudden drop in oxygen saturation during labor or surgery. Fulminant type: mainly characterized by symptoms of pulmonary hypertension (respiratory and circulatory failure as the main symptom): acute onset, sudden cough, difficulty breathing, severe cyanosis; chills, chest tightness, shortness of breath, convulsions, coma or shock of unexplained cause.

2. Bleeding: Slow type: Unexplained postpartum bleeding, oozing blood, continuous trickle, non-coagulated blood, and initial shock that is disproportionate to the amount of bleeding. The use of uterotonics was ineffective.

4. Coagulation dysfunction: systemic bleeding may occur.