Amniotic fluid embolism - review and multicentric case analysis

Area of Science:

• Obstetrics
• Cardiology
• Critical Care Medicine

Background:

• Amniotic fluid embolism (AFE) is a rare, life-threatening obstetric emergency.
• It presents with sudden cardiovascular collapse, respiratory distress, seizures, and disseminated intravascular coagulation (DIC).
• Patient response is often biphasic, involving initial pulmonary and right ventricular failure, followed by left ventricular failure.

Purpose of the Study:

• To critically review current knowledge on AFE epidemiology, pathophysiology, diagnosis, and treatment.
• To highlight the critical need for early AFE recognition and aggressive management.
• To address controversial aspects of AFE management based on available evidence.

Main Methods:

• Systematic review of existing literature on Amniotic Fluid Embolism.
• Critical examination of epidemiological data.
• Analysis of pathophysiological mechanisms and diagnostic criteria.
• Evaluation of current treatment strategies and outcomes.

Main Results:

• AFE remains a significant cause of perinatal morbidity and mortality.
• Early diagnosis and aggressive, multidisciplinary shock management improve survival rates.
• Neurological sequelae are common in surviving patients.

Conclusions:

• Despite its rarity, AFE poses a severe risk to mothers and newborns.
• Further research is needed to resolve controversies and optimize AFE management.
• Collaborative care involving anesthesiologists is essential for effective shock management.