Which pregnant women are prone to amniotic fluid embolism?

Most people will turn pale when talking about amniotic fluid embolism. Everyone knows that amniotic fluid embolism is a very common disease during pregnancy. It is an extremely dangerous obstetric complication with a very high mortality rate. In fact, amniotic fluid embolism simply means that when a pregnant woman is giving birth, amniotic fluid enters the pregnant woman's body and circulates in the blood. If the amniotic fluid enters the blood, it will cause organ failure of the pregnant woman. So what kind of pregnant women are prone to amniotic fluid embolism?

The following people are at high risk of developing amniotic fluid embolism:

1. Older pregnant women: that is, pregnant women over 35 years old, have a higher chance of occurrence. The older they are, the greater the possibility of occurrence.

2. Mothers who have given birth many times: for example, mothers who are giving birth to their third, fourth, or even seventh or eighth child. The more babies they give birth to, the higher the rate of amniotic fluid embolism.

3. Patients with placental abruption: During the delivery process, if placental abruption occurs, the possibility of fetal cells, vernix caseosa or meconium in the amniotic fluid entering the maternal blood through the placental veins will increase.

4. Pregnant women whose fetus dies in the uterus: The longer the fetus dies in the uterus, the higher the chance of amniotic fluid embolism.

5. When there is fetal distress, the chance of amniotic fluid embolism is also relatively high. Because when the fetus is in distress, there is often meconium in the amniotic fluid. The labor pain is usually very intense at this time, and amniotic fluid embolism is more likely to occur.

6. Women who use oxytocin to induce labor and experience very severe labor pain are also more likely to develop amniotic fluid embolism.

Causes of amniotic fluid embolism

Three major causes: premature rupture of the placenta, abnormal uterine blood vessel opening, and large changes in uterine cavity pressure

First, premature rupture of the placenta causes the outflow of amniotic fluid, and the separation of the fetal membrane and the cervical wall causes blood vessel damage. The amniotic fluid may enter the maternal blood circulation through the cervical mucosal veins and the venous sinuses at the placental attachment site. If there are strong and irregular uterine contractions at this time, the amniotic fluid will quickly enter the ruptured blood vessels, causing the body's allergic reaction and abnormal coagulation mechanism, causing a series of pathophysiological changes-amniotic fluid embolism.

The second is abnormal opening of uterine blood vessels: if the uterus ruptures during childbirth in a scarred uterus, there will also be vascular abnormalities. If the amniotic fluid breaks, it will flow into the blood vessels and cause amniotic fluid embolism.

In addition, some women who have premature births or multiple births are relatively susceptible to the infection because of the large changes in uterine pressure during delivery. Because multiparous pregnant women give birth to more babies faster, the birth canal is more damaged, especially lacerations of the lower uterine segment and cervix. Once the laceration occurs, the vascular channel is open and amniotic fluid can more easily enter the maternal vascular system. If oxytocin is not used appropriately during the induction of labor, there will be too strong and frequent uterine contractions. At this time, due to the excessive pressure in the uterine cavity, blood vessels may rupture and amniotic fluid embolism may occur more easily.