This condition is truly devastating, and there are no warning signs. The low blood pressure leads to cardio-vascular collapse, which causes fetal distress and can lead to the death of the infant if he or she is not delivered immediately. DIC causes blood to leak from the body because it can no longer clot. Those patients who do survive enter the second phase of AFE, the hemorrhagic phase, which is often accompanied by severe shortness of breath, shivering, coughing, vomiting, and excessive bleeding due to a condition called DIC (disseminated intravascular coagulation). Most patients lapse into a coma within moments, and 60–80 percent of patients do not survive long enough to make it through this first phase of amniotic fluid embolism. Cardiac arrest can quickly follow, as the chambers of the heart do not get enough blood to circulate to the body. During phase one, the patient begins to experience shortness of breath and a sudden drop in blood pressure (hypotension). When it happens, a doctor has no more than three minutes to notice symptoms, properly diagnose the problem, and react. The reason why this occurs in some women and not others is still not well understood. The effect is like giving a pregnant woman a transfusion of a large volume of amniotic fluid. Something happens suddenly that allows some amniotic fluid (which contains many different chemicals, hormones, and fetal skin cells) to enter the mother’s veins and then circulate in her blood stream. The most likely time for this thankfully very rare event to occur is during delivery, or during a pregnancy termination. AFE occurs when the barrier between the amniotic fluid and maternal circulation is broken, and the amniotic fluid enters the mother’s venous system. In a normal patient, amniotic fluid doesn’t enter the maternal circulation system it remains safely contained inside the uterus, sealed off by the amniotic sac. While AFE is unpredictable, unpreventable, and can be a life-threatening pregnancy complication, it is also very rare-occurring in only one out of every 21,000 pregnancies-but it may be useful to at least have heard of it. An amniotic fluid embolism (AFE) can be a devastating blow to what was supposed to be a joyful experience.
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