Although its rare, Amniotic fluid Embolism Treatment syndrome of amniotic fluid embolism (AFE) is well known to anesthesiologists.
Given its sudden and dramatic appearance and often devastating consequences, practitioners who have been given the responsibility of looking after an unfortunate woman with AFE will remember that experience in great detail for a long time. AFE is initiated by the entry of amniotic fluid into the maternal circulation and is characterized by sudden onset of labor, delivery, or early onset of puerperium, followed by sudden onset of tachypnea and cyanosis.
In addition, the contents of the amniotic fluid were isolated in the blood and sputum of pregnant women who had no clinical evidence of AFE. AFE may cause mild organ dysfunction in some women, in others it may lead to coagulopathy, cardiovascular collapse, and death. Understanding the etiology and pathophysiology is incomplete in this case and the criteria used to make its diagnosis are controversial. Yet, despite advances in the care of sick patients, no management intervention has been found to improve the survival or long-term outcome of a woman with AFE.
- Diagnosis of amniotic fluid embolism treatment is usually done after ruling out other conditions.
- Your health care provider may order the following laboratory tests during your evaluation:
- Blood tests for blood clotting, heart enzymes, electrolytes, and blood type assessment, as well as complete blood count (CBC)
- Electrocardiogram (ECG or EKG) to assess your heart rate
- Pulse oximetry is to check the amount of oxygen in your blood
- Chest x-ray for fluid around your heart
- Echocardiography to assess your heart function
- Amniotic fluid embolism treatment requires continues and frequent treatment to address low blood oxygen and low blood pressure.
- Emergency treatments may include:
- Catheter placement. A thin, hollow tube placed in one of your arteries (arterial catheter) is used to monitor your blood pressure. There may also be another tube in the vein in your chest (central venous catheter), which can be used to deliver fluids, drugs or blood transfusions, as well as to draw blood.
- Oxygen. You may need to insert a breathing tube into your airway to help you breathe.
- Drugs. Your doctor may give you medications to improve and support your heart function. Other medications may be used to relieve stress caused by fluid flowing into your heart and lungs.
- If you have uncontrolled bleeding, you need blood, blood products, and replacement fluids.
- If you have amniotic fluid embolism before giving birth, your doctor will treat you with the goal of delivering your baby safely. An emergency C-section may be required.
Coping and support
Experiencing a life-threatening pregnancy can be frightening and stressful for you and your family. Later, you can restore the experience and have nightmares and flashbacks.
During this challenge, lean on loved ones for support. Consider joining a survivor’s network. Also, work with your health care provider to learn how you can safely manage your recovery and your role as a mother of a newborn.
- There are no specific laboratory tests that confirm the diagnosis, but some tests support the diagnosis. Initial laboratory data should include:
- Arterial blood gas to assess ventilation and hypoxemia level;
- Hematocrit drops with associated bleeding;
- The number of white cells can be increased to acute phase reactant;
- Chronic prothrombin and thromboplastin times with decreased fibrinogen levels in addition to DIC;
- Levels of cardiac enzymes and serum tryptase can be increased;
- Chest radiography reveals pulmonary edema but not pathology;
- Echocardiography demonstrates acute left heart failure, severe right heart failure, or severe pulmonary hypertension.