Amniotic fluid embolism: antepartum, intrapartum and demographic factors

Abstract

Several antepartum and peripartum conditions and procedures are associated with significantly higher risks of amniotic fluid embolism. This information may contribute to a better understanding of the pathophysiology of AFE and potentially help identify those at the highest risk of developing this morbid condition.

2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)

“…Reported case fatality rates vary, reflecting the challenges in making the diagnosis and the rarity of AFE. In a retrospective Californian study including more than 3.5 million deliveries, a case fatality rate of 13% was reported, as in other US and Canadian studies [425]. Similarly, a case fatality rate of 19% was reported in a recent prospective UK population-based study with validated case criteria [422].…”

“…AFE is characterized by unexplained sudden cardiovascular or respiratory deterioration, often accompanied by disseminated intravascular coagulation [422], and occurring during pregnancy or after delivery [423,424]. The reported incidence is approximately 2-7 per 100 000 maternities, with a mortality rate of 0.5-6 deaths per 100 000 deliveries [422,425,426]. Reported case fatality rates vary, reflecting the challenges in making the diagnosis and the rarity of AFE.…”

Amniotic fluid embolism mortality rate

“…Population-based amniotic fluid embolism (AFE) maternal mortality rate Since Gilbert et al's study in 1999, at least 13 populationbased studies examining the maternal mortality rate of AFE have been published ( Table 1). [4][5][6][7][8][9][10][11][12][13][14][15][16] The data from a 13th study by Kramer et al births, the total number of AFE cases or the total number of deaths, the other nine reports contained this information. 10,12,16 The aggregate data from these nine studies is presented in Table 2.…”

Amniotic fluid embolism: Pathophysiology from the perspective of pathology

“…The mortality rate due to AFE remains high and has been estimated at between 5 and 15 % of all maternal deaths in developed countries . In the USA, the incidence is 5.1 % in 100 000 deliveries, with a case fatality rate of 13.2 % . Maternal mortality rates due to AFE have been estimated at between 24 and 80 %.…”