Amniotic fluid embolism
Amniotic fluid embolism refers to a syndrome in which the contents of amniotic fluid, such as vernix caseosa, keratinized epithelial cells, meconium, and vellus, enter the maternal blood circulation during delivery, 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 is mostly due to excessive or rigid uterine contractions, high intrauterine pressure, and amniotic fluid entering the maternal blood circulation through the lacerated endocervical veins shortly after or after the rupture of the fetal membranes. The disease should be suspected if unexplained dyspnea, cyanosis, shock, and uterine hemorrhage suddenly occur during delivery. Treatment includes anti-allergic, oxygen supply, relief of pulmonary hypertension, blood volume supplementation, anti-shock, and correction of DIC. If the fetus is not delivered, delivery should be ended immediately. Amniotic fluid embolism has an acute onset and a severe condition, and most women die shortly after onset. Avoiding inducing factors, timely diagnosis, and organizing rescue and treatment as soon as possible are the keys to rescue and survival.
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