Amniotic fluid embolism.

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Pathophysiology

Background:

• Amniotic fluid embolism (AFE) is a rare obstetric emergency.
• It is a leading cause of maternal mortality in the United States, with a high fatality rate (60%-80%).
• Survivors often experience severe long-term neurologic disability.

Purpose of the Study:

• To review the largest case series on amniotic fluid embolism to date.
• To better understand the pathophysiology of AFE.
• To evaluate the clinical manifestations and compare them to other shock syndromes.

Main Methods:

• Review of the largest available case series on amniotic fluid embolism.
• Analysis of the physiologic and hematologic manifestations of AFE patients.
• Comparison of AFE's clinical presentation with septic shock and anaphylactic shock.

Main Results:

• The pathophysiology of amniotic fluid embolism is not well understood.
• Physiologic and hematologic findings in AFE resemble septic and anaphylactic shock more than embolic events.
• Patient care for AFE is primarily supportive.

Conclusions:

• Amniotic fluid embolism presents with unique clinical features distinct from typical embolic phenomena.
• Further research is needed to elucidate the pathophysiology of AFE.
• Currently, no specific therapies improve survival rates for amniotic fluid embolism.