AMNIOTIC FLUID EMBOLISM DURING PREGNANCY OR DELIVERY
a. Description. Amniotic fluid embolism refers to the accidental infusion of
amniotic fluid into the mother's bloodstream under pressure from the contracting uterus.
The amniotic fluid enters the maternal blood sinuses through defects in the membranes,
after membranes have ruptured or after partial premature separation of the placenta has
occurred. Solid particles suspended in the amniotic fluid enter the maternal circulation
(this may be fetal skin cells carried to the lungs as emboli) and produces dramatic
clinical symptoms of pulmonary embolism. This is a common cause of death among
mothers who die suddenly during labor.
b. Assessment for Amniotic Fluid Embolism. Amniotic fluid embolism is
characterized by sudden dyspnea, chest pain, tachycardia, hypotension, and typical
bluish, gray seen in patients with a pulmonary embolism. Death may occur within
minutes without immediate intervention. Death may be maternal or fetal.
c. Medical and Nursing Interventions for Amniotic Fluid Embolism.
Give immediate and vigorous treatment.
Give oxygen by face mask.
(3) Maintain normal blood volume through administration of plasma and
(4) Prevent development of disseminated intravascular coagulation (DIC).
Serious complications can occur.
Administer whole blood and fibrinogen.
Monitor the patient's vital signs.
Deliver the fetus as soon as possible.
Disseminated intravascular coagulation is an acute abnormal stimulation of
the normal coagulation process. The normal clotting process is a balance
between clot formation and dissolution. In DIC, the balance is disrupted. The
abnormal stimulation of coagulation results in widespread thrombi formation
that eventually exhausts clotting factors and platelets and activates the
process that dissolves fibrogen. Major bleeding results.
FACTS ABOUT MULTIPLE PREGNANCY AND DELIVERY
(1) Multiple pregnancy is the presence of two or more fetuses in the uterus
at the same time.