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Amniotic fluid embolism: decreased mortality in a population-based study.

W M Gilbert1, B Danielsen

  • 1Department of Obstetrics and Gynecology & Center for Health Services Research in Primary Care, University of California, Davis, Sacramento 95817, USA. wmgilbert@ucdavis.edu

Obstetrics and Gynecology
|June 11, 1999
PubMed
Summary

Amniotic fluid embolism occurred in 1 in 20,646 deliveries, with a maternal mortality rate of 26.4%. This rate is lower than previously reported, suggesting improved accuracy in identifying this rare pregnancy complication.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatal Epidemiology

Background:

  • Amniotic fluid embolism (AFE) is a rare but often fatal obstetric emergency.
  • Accurate population-based data on AFE incidence and outcomes are crucial for understanding its impact.

Purpose of the Study:

  • To determine the incidence, risk factors, and pregnancy outcomes of amniotic fluid embolism (AFE) in California.
  • To compare maternal mortality rates and complication frequencies in AFE cases.

Main Methods:

  • Utilized a linked database of birth certificates and hospital discharge summaries for singleton deliveries in California (1994-1995).
  • Analyzed 53 confirmed cases of amniotic fluid embolism, examining maternal complications and outcomes.
  • Compared characteristics between AFE survivors and non-survivors.

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Main Results:

  • The population frequency of AFE was 1 per 20,646 deliveries, with a maternal mortality rate of 26.4%.
  • Common complications included disseminated intravascular coagulation (DIC) (66%), hemorrhage (72%), and obstetric shock (47%).
  • Obstetric shock was significantly higher in non-survivors (86%) compared to survivors (33%).

Conclusions:

  • The observed maternal mortality rate for AFE is lower than previously reported, potentially reflecting a more accurate population frequency.
  • Similar pregnancy complication profiles between survivors and non-survivors suggest AFE diagnosis was consistently applied.
  • This study provides valuable population-based insights into the epidemiology and outcomes of amniotic fluid embolism.