Child birth at Risk: Amniotic Fluid Embolism

  • Occurs when amniotic fluid is forced into an open maternal uterine blood sinus through some defect in the membranes or after membranes rupture or abruptio placenta.
  • Solid particles in the amniotic fluid such as skin cells may enter maternal circulation and reach the lungs as small emboli.
  • It may occur during labor or in the post-partal period.
  • Unpreventable
  • Risk factors include:

1. Oxytocin administration
2. Abruptio placenta
3. Polyhydramnios

  • Assessment: Dramatic clinical picture

- Woman in strong labor sits up suddenly and grasps her chest because of inability to breathe and sharp pain.
- Marked pallor progressing to cyanosis.

  • Management:

- Oxygen administration of facemask or cannula.
- Start CPR as necessary.
- Prognosis depends on the size of the emboli and the speed and adequacy of emergency measures given to her.
- DIC may develop from the presence of particles in the blood stream. In this situation, intubation and fibrinogen therapy may be necessary.
- Close maternal and fetal monitoring.


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