A young TikToker dies of an amniotic fluid embolism during childbirth, her child is in an artificial coma. What causes this rare complication? And why is it life-threatening?
Amniotic fluid embolism is – fortunately – a very rare event in which the mother’s heart and circulation fail during or shortly after birth. “As this emergency cannot be foreseen, unfortunately any help often comes too late unless intensive care is immediately available,” says Wolfgang Paulus from the Department of Gynecology and Obstetrics at the University of Ulm. Due to the rarity, many obstetricians have little experience in dealing with amniotic fluid embolism. In smaller facilities, at most one or two cases occur per decade, says the doctor specializing in special obstetrics and perinatal medicine, adding: “We at university medicine also have great respect for such an event!”
How does an amniotic fluid embolism occur?
The exact mechanisms are not clearly understood. “Despite its name, the disease probably has no direct connection to the amount of amniotic fluid that has leaked out or an embolism, i.e. a sudden blockage of a blood vessel,” says Paulus. It is assumed that amniotic fluid embolism is a pathological maternal reaction to foreign material such as placental tissue, amniotic fluid and fetal cells that enter the maternal circulation when vessels in the uterus rupture during birth.
What happens when the foreign material enters the mother’s bloodstream?
The body releases inflammatory messengers that lead to a cascade of physical reactions: the function of the heart, circulatory system and lungs is restricted. The lungs can no longer absorb oxygen, the heart does not pump properly, so the organs do not receive enough oxygen and nutrients. The pulmonary vessels constrict; the increased resistance causes blood pressure to drop. The coagulation system is also activated in a fatal way. On the one hand, clots block the vessels; on the other hand, bleeding, such as birth injuries, can no longer be stopped.
How does this affect the baby?
The unborn child is also at risk. Due to the failure of the mother’s cardiovascular system, it no longer receives sufficient care. An emergency Caesarean section may have to be performed and the child resuscitated. How well a child survives this dramatic event depends on how long it was without oxygen and how quickly it received intensive medical help.
What are the risk factors for amniotic fluid embolism?
The causes are not fully understood, but some risk factors are known:
- older age of the mother
- a multiple pregnancy
- Complications with the placenta, for example if it is located close to the cervix or has grown particularly deeply into the uterine wall
- rapid or strong contractions
- Caesarean section, forceps or vacuum extraction
- too much amniotic fluid
What are the signs of amniotic fluid embolism?
The first symptoms result from the maternal lack of oxygen and heart problems:
- sudden shortness of breath because the pulmonary vessels are narrowed and the lungs no longer function properly
- Drop in blood pressure leading to circulatory shock
- bluish skin and lips due to lack of oxygen
- Pain or tightness in the chest due to lack of oxygen to the heart
- Cardiac arrest
The symptoms usually appear very suddenly.
How do you treat an amniotic fluid embolism?
“We are dealing with a very difficult to treat condition,” says birth expert Paulus. In any case, amniotic fluid embolism is a medical emergency in which mother and child need immediate intensive treatment: ventilation, medication to support the circulation, clotting factors and blood transfusions. The prognosis for the course of the emergency depends on how quickly the amniotic fluid embolism is recognized and treated. Nevertheless, the options available in modern medicine are not sufficient in many cases.
Source: Stern
I’m Caroline, a journalist and author for 24 Hours Worlds. I specialize in health-related news and stories, bringing real-world impact to readers across the globe. With my experience in journalism and writing in both print and online formats, I strive to provide reliable information that resonates with audiences from all walks of life.
