Second cause of maternal death linked to pregnancy, amniotic embolism is an unpredictable and rare accident corresponding to the passage of amniotic fluid into the maternal bloodstream during childbirth. The vital prognosis of mother and baby depends on the speed of diagnosis and the initiation of adequate treatment.

Amniotic embolism is most likely the result of amniotic fluid passing into the maternal circulation during labor or expulsion. Debris naturally present in the amniotic fluid (squamous cells, down, mucus, fatty elements, etc.) migrate to the mother’s lungs where they obstruct the arteries, causing acute respiratory distress. Coagulation disorders, cardiac arrest, failure of vital organs also quickly occur.

It is very difficult to know the frequency of amniotic embolism. It would concern between 1 / 8000 to 1 / 80000 pregnancies. The frequency of death from amniotic embolism is also poorly understood. It is still very high, sometimes greater than 30% depending on the studies, but it is decreasing.

Amniotic embolism cannot be predicted or prevented. However, it seems that the risk increases with a cesarean delivery, the use of forceps, advanced maternal age, multiple pregnancy, premature placental abruption, abdominal trauma, placenta previa.

Amniotic embolism is most often manifested by discomfort, breathing difficulties, convulsions, hemorrhage, a sudden drop in blood pressure often leading to cardiac arrest.

The mother’s vital prognosis can be improved by rapid diagnostic and therapeutic treatment (cardiopulmonary resuscitation, oxygen therapy, blood transfusion, etc.) most often requiring transfer to a specialized unit.

If the baby has not yet come into the world, an emergency cesarean section is required to limit the after-effects linked to the lack of oxygenation.