Amniotic Fluid Embolism (AFE): Causes, Symptoms & Risks

Amniotic fluid embolism (AFE) is a rare but serious pregnancy complication occurring when amniotic fluid and fetal material enter the mother's bloodstream. This triggers a severe allergic-like reaction causing respiratory distress, cardiovascular collapse, and disseminated intravascular coagulation (DIC).

AFE is a leading cause of maternal death in the U.S., accounting for up to 15% of pregnancy-related deaths.

Potential Causes

• Rupture of amniotic membranes
• Passage of amniotic fluid/fetal material into maternal circulation
• Activation of complement cascade (immune system)
• Release of inflammatory mediators damaging lungs, heart, other organs

Symptoms

• Sudden shortness of breath
• Chest pain
• Coughing up frothy, pink sputum
• Rapid heart rate
• Low blood pressure
• Seizures
• Coma

Treatment

AFE is a medical emergency requiring immediate treatment. Goals: support vital signs, prevent complications.

• Oxygen therapy
• IV fluids
• Blood transfusions
• Medications to stop bleeding and improve heart function
• Emergency delivery of baby

Prognosis

Depends on severity and promptness of treatment. With early intervention, most women survive. However, AFE can be fatal in up to 20% of cases.

Risk Reduction

• Avoid activities risking membrane rupture (contact sports, vigorous exercise).
• Seek prompt medical attention for preterm labor signs.
• Follow doctor's prenatal care instructions.