After last weeks fascinating case discussion, Nolan and I continue with our discussion on amniotic fluid embolism. In this discussion we drill down into some of the current theories and understanding of the pathophysiology, prevalence, risk factors and AMOSS, the Australasian Maternities Outcomes Surveillance System, which has focussed on AFE in Australasia.
The exact biological mechanism of AFE is still not fully understood as this is a rare unpredictable condition with no reproducible animal model which makes it exceedingly difficult to study. The knowledge we currently have has been gleaned from descriptions of case reports / case series and the pathophysiology that was observed. Current theories favour the condition to be an immune mediated reaction triggered by maternal exposure to fetal amniotic fluid and that the term “embolism” may be misleading.
Listen to our podcast above for some more nuanced discussion on this topic. If anyone has any comments, questions or personal experiences they’d like to share please leave us a comment we’d love hear from you!
- AMOSS, the Australasian Maternities Outcomes Surveillance System: https://www.amoss.com.au/
- Society for Maternal-Fetal Medicine (SMFM) with the assistance of Pacheco LD, Saade G, et al. Amniotic fluid embolism:diagnosis and management. Am J Obstet Gynecol 2016;Aug;215(2):B16-24.
- McDonnell NJ, Percival V, Paech MJ.Amniotic fluid embolism: a leading cause of maternal death yet still a medical conundrum. Int J Obstet Anesth. 2013 Nov;22(4):329-36
Listen to last weeks fascinating case of AFE: