amniotic fluid embolism

  1. Hi all,
    I'm an RN in a community clinic and we do a lot of prenatal care. We recently had a pt die during a planned c-sec. The cause I was given was an amniotic fluid embolism.

    Does anyone know anything about this? Can you explain this to me in a little more detail or let me know where I can find out more?

    The baby did survive, luckily. What a tragic situation! As a relatively new mom myself this pt's death has really effected me. Plus you really get attached to some pts when you see them over a course of a pregnancy.

    I just would like to learn more about the pathology behind this. TIA!

    Alma
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  2. 15 Comments

  3. by   sirI
    Hello, Almabella,

    I've seen a few in my career. Yes, very tragic and devastatingly sad.

    Here are a few links for you:

    http://www.emedicine.com/med/topic122.htm

    http://www.medscape.com/viewarticle/410590

    http://www.medscape.com/viewarticle/546393
  4. by   ElvishDNP
    Unfortunately, it seems to be one of those things that can't be predicted nor fixed once it happens. You are very very lucky if you survive it. I haven't seen it personally, but several of my coworkers have. I just have been lucky enough to not be at work when it happens.
  5. by   NurseNora
    I've taken care of 2 patients with Amniotic Fluid Emblolism, they both died. The first one complained after delivery of feeling faint and mildly SOB. She went to the recovery room after delivery where she was found to be hypotensive and disoriented. She was brought back to the DR in full blown DIC and a code was called. She died despite prolonged resuscitation attempts and massive blood and blood component transfussions.

    The second patient went down hill more quickly. She turned to her husband and said she felt sick, threw up and died. Of course, we coded her for a long time, but she never got pink. We did get the baby born quickly, within 5 min of calling the code, and the baby had 8/9 Apgars. CPR was never adequate because of the junk in her lungs and the reaction to that and again, she went into DIC as a result of the fetal junk in her circulation.

    They say that some people do survive this, but not often and usually not neurologically intact. It's tragic, and unpredictible.
  6. by   RNLaborNurse4U
    I have never seen an AFE, and I hope I never do.
  7. by   LizzyL&DRN
    We've only had one on our unit that I've heard of. She presented as a full term fetal demise patient and we were inducing her labor. The MD broke her water and she sat up for an epidural got SOB and went down hill very fast and unfortunatly died. I hope I never see or hear of one again. My condolences to you Almabella.
  8. by   OzMW
    Quote from RNLaborNurse4U
    I have never seen an AFE, and I hope I never do.
    :yeahthat:
  9. by   CEG
    Quote from Almabella
    Hi all,
    I'm an RN in a community clinic and we do a lot of prenatal care. We recently had a pt die during a planned c-sec. The cause I was given was an amniotic fluid embolism.

    Does anyone know anything about this? Can you explain this to me in a little more detail or let me know where I can find out more?

    The baby did survive, luckily. What a tragic situation! As a relatively new mom myself this pt's death has really effected me. Plus you really get attached to some pts when you see them over a course of a pregnancy.

    I just would like to learn more about the pathology behind this. TIA!

    Alma
    I read a study recently that women induced with pitocin have a 2 X risk of DIC. Here is a link to a vague page of a book that talks about pitocin and dic risk: http://books.google.com/books?id=d2b...n-xf30gHTw3LY0 I haven't seen one in my short career and cartainly hope I never do.
  10. by   alianeco
    Wow. I haven't seen one yet and hope I never do.
    I've heard of them happening with amnioinfusions and I'm a bit nervous each time I do one.
  11. by   33-weeker
    We recently had one. I wasn't involved but heard about it later. The mom was very ill, went into DIC, had some strokes and was not initially expected to survive. The nursery nurse who took the baby to visit her in ICU was very shaken by the whole experience. The docs and nurses in ICU were tearful with the baby's visit - thinking at the time that mom was not going to survive. Then later I heard that the mom's condition had taken a turn for the better. She will need rehab. but will survive.

    Thank goodness its rare.
  12. by   zerby1470
    I experienced my first one yesterday, and I am still trying to process it. Mom was laboring fine, got her epid., doing fine. Coded. got her to the section room, baby coded 3 times. Mom in DIC. As of now, mom is still living, but sick, sick, sick. Unsure of the baby. Bad situation all around. I hope never to see anything like it again.
  13. by   nurturing_angel
    I have never experienced one and I pray each day not too. I have 2 nurse friends who had pts experience it. No survivors......both moms and babes died. So sad. Give me the prolapsed cords, the previas, the abruptions and the ruptured uterus'. At least we have a chance there. I do not want a AFE!!!



  14. by   ElvishDNP
    Oh gosh, angel. That's awful.

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