The Amniotic Fluid

There is a vital need for a nonrestricting intrauterine

environment, which develops before the fetus. This
environment can only be ensured if it is part of the
development of the fetus. Every fetus is surrounded by a
protective cushion of amniotic fluid, whether the fetus
develops inside the mother as a viviparous species or in an egg.

The average volume of amniotic fluid at

term is 800 mL, and the sodium
concentration is fairly constant.
The volume and sodium concentration
remain the same despite the fact that a
normal fetus will swallow some of the
fluid .

Amniotic fluid embolism

Definition

An amniotic fluid embolism is a rare but serious condition that

occurs when amniotic fluid the fluid that surrounds a baby in
the uterus during pregnancy or fetal material, such as hair,
enters the maternal bloodstream. An amniotic fluid
embolism is most likely to occur during childbirth or
immediately afterward.
An amniotic fluid embolism is difficult to diagnose. If your doctor
suspects you might have an amniotic fluid embolism, you'll
need immediate treatment to prevent potentially lifethreatening

Causes
Why an amniotic fluid embolism occurs isn't well
understood.
An amniotic fluid embolism occurs when amniotic fluid or
fetal material enters the maternal bloodstream, possibly by
passing through tears in the fetal membranes. It's likely that
amniotic fluid contains components that cause an
inflammatory reaction and activate clotting in the mother's
lungs and blood vessels.
However, amniotic fluid embolisms are rare and it's likely
that some amniotic fluid commonly enters the maternal
bloodstream during delivery without causing problems. It's
not clear why in some cases this leads to an amniotic fluid
embolism.

Amniotic Fluid Embolism

Amniotic fluid embolism is a pregnancy complication
that causes lifethreatening conditions, such as heart
failure.It can affect you, your baby, or both of you. It
happens when amniotic fluid, or the fluid surrounding
your unborn child, make way into your blood.
It is rare. Though estimates vary, the AFE Foundation
says it occurs in only one in every 15,200 deliveries in
North America. However, it is a leading cause of death
during labor or shortly after birth. It cannot be
prevented, and the underlying cause of it is not fully
understood.

Causes
AFE can happen during labor or shortly after
giving birth in both vaginal and cesarean
births. In rare cases, it can happen during an
abortion or while having a small sample of
amniotic fluid taken for
examination(Amniosentences). AFE is an
adverse reaction that occurs when amniotic
fluid enters your circulatory system.

Symptoms
The first stage of AFE usually includes cardiac
arrest.and rapid respiratory failure. Cardiac arrest
occurs when your heart stops working and you
lose consciousness and stop breathing. Rapid
respiratory failure occurs when your lungscannot
supply enough oxygen to your blood or remove
enough carbon dioxide from it. This makes it very
difficult to breathe.

Mother
Treatment involves managing symptoms and preventing
AFE from leading to coma or death. Oxygen therapy or a
ventilator can help you breathe. Making sure that you are
getting enough oxygen is crucial so that your baby also has
enough oxygen. You also might have a pulmonary artery
catheter inserted so that your doctors can monitor your
heart. Medications might also be used to control your
blood pressure. In many cases, several blood, platelet, and
plasma transfusions are needed to replace the blood lost
during the hemorrhagic phase.
Infant
Your doctor will monitor your baby and watch for signs of
distress. Your baby will most likely be delivered as soon as
your condition is stabilized.

Causes
Why an amniotic fluid embolism occurs isn't well understood.
An amniotic fluid embolism occurs when amniotic fluid or fetal
material enters the maternal bloodstream, possibly by passing
through tears in the fetal membranes. It's likely that amniotic fluid
contains components that cause an inflammatory reaction and
activate clotting in the mother's lungs and blood vessels.
However, amniotic fluid embolisms are rare and it's likely that
some amniotic fluid commonly enters the maternal bloodstream
during delivery without causing problems. It's not clear why in
some cases this leads to an amniotic fluid embolism.
Further research on what causes amniotic fluid embolisms is
needed

Background
Amniotic fluid embolism (AFE) is a rare
obstetric emergency in which it is postulated
that amniotic fluid, fetal cells, hair, or other
debris enter the maternal circulation, causing
cardiorespiratory collapse.
In 1941, Steiner and Luschbaugh described
AFE for the first time after they found fetal
debris in the pulmonary circulation of women
who died during labor.

 The diagnosis of AFE has traditionally been made at

autopsy when fetal squamous cells are found in the
maternal pulmonary circulation; however, fetal
squamous cells are commonly found in the circulation
of laboring patients who do not develop the syndrome.
In a patient who is critically ill, a sample obtained by
aspiration of the distal port of a pulmonary artery
catheter that contains fetal squamous cells is
considered suggestive of but not diagnostic of AFE
syndromeResource

 In a patient who is critically ill, a sample

obtained by aspiration of the distal port
of a pulmonary artery catheter that
contains fetal squamous cells is
considered suggestive of but not
diagnostic of AFE syndromeResource