Amniotic fluid embolism, a serious complication of pregnancy

Pregnancy has its share of potentially serious complications for both mother and child. In particular, the most common include arterial hypertension, which is likely to develop into pre-eclampsia or even eclampsia, gestational diabetes or even the threat of premature birth. So many pathologies well known to obstetricians and gynecologists who, thanks to early diagnosis and proper care, manage to preserve the health of both mother and child. But there is another complication that is extremely rare but very serious: amniotic fluid embolism. Why is ? To what extent is the vital prognosis of mother and child affected? Is there a treatment? dr Tiphaine Beillat, obstetrician-gynecologist, member of the National Federation of Colleges of Medical Gynecology (FNCGM), sheds light on this topic.

What is an amniotic fluid embolism?

Amniotic embolism refers to a rare but very serious complication of childbirth. Its prevalence is estimated at 2 to 6 pregnancies in 100,000 Passage of elements contained in amniotic fluid (Squamous cells, fat particles, debris, mucus, fetal tissue…) by doing sang the future mother. They travel to his lungs and cause the equivalent of a pulmonary embolism (Blockage of an artery in the lungs). “This is followed by very severe coagulation disorders, acute respiratory distress syndrome, cardiac arrest and progressive organ failure. This phenomenon is violent and generally occurs at the time of labor, more precisely when the bag of water ruptures.says dr Tiphaine Beilat.

What are the causes of an amniotic fluid embolism?

An amniotic fluid embolism is as unpredictable as it is inevitable and can affect any woman. “Its causes are poorly understood and it is unclear why it is more common in some women than others. However, it appears that certain situations increase the risk of developing an amniotic fluid embolism, in particular: a twin pregnancy, a cesarean delivery, the use of forceps-like instruments at the time of delivery, an abnormality of the placenta (placental rupture). or placenta previa, which corresponds to under-implantation of the placenta), excess amniotic fluid, induction, advanced maternal age, or even uterine rupture”says the obstetrician-gynecologist.

What are the symptoms and consequences of an amniotic fluid embolism?

An amniotic fluid embolism essentially leads to an increase in the maternal heart rate, a drop in blood pressure, malaise, difficulty breathing or even generalized bleeding. These are all symptoms that can lead to acute shortness of breath or cardiac arrest. Given these signs, the medical team must Make a diagnosis of amniotic fluid embolism as soon as possible to properly care for and preserve them Life prognosis of mother and child. « The diagnosis is often confirmed by bronchioalveolar lavage, in which a fluid is injected into the bronchi and alveoli through a fiberscope to extract cells from the amniotic fluid.Details of our interlocutor.

What is the treatment for amniotic fluid embolism?

There is no no treatment to stop the development of amniotic fluid embolism. Management is mainly based on the so-called supportive care, viz oxygen therapy and the resuscitation. A blood transfusion may be needed, and the mother may be injected with a blood clotting factor. The baby can be delivered vaginally, most often with the help of forceps or a suction cup, or by cesarean section.

“Amniotic fluid embolism is unpredictable and difficult to control. Unfortunately, there is no way to prevent this. Obstetricians fear this pregnancy complication, but fortunately it remains the exception.” informs Dr. Tiphaine Beilat.

thanks to dr Tiphaine Beillat, obstetrician and gynecologist, member of the FNCGM, who practices at the Mathilde Clinic.

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