AMNIOTIC FLUID EMBOLISM (AFE) : WHICH ARE THE CONSISTENT CLINICAL FEATURES @ PRESENTATION?

Hypotension , Hypoxemia and DIC are hallmarks (MNEMO> “AFE is Highly Dangerous”)

Hypotension & Fetal Distress occur in 100% of cases

DIC occur in 83% and indicate a bad prognosis

Cardiac arrest occur in around 87% of patients

Mortality is >60% ; it has been observed that only 15% survive with intact neurological function

Pulmonary Hypertension, CHF and DIC are key events in the pathogenesis

Pulmonary edema (occur in >90% of cases), Dyspnoea (occur in 49%) & Bronchospasm (occur in 15%) are the respiratory signs

Reference: Dedhia JD, Mushambi M. Amniotic fluid embolism. Contin Educ Anaesth Crit Care Pain. 2007; 7(5): 152–156. Gist RS, Stafford IP, Leibowitz AB et al. Amniotic fluid embolism. Anaesth Analg. 108(5): 1599–1602.