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Risk factors, management, and outcomes of amniotic fluid embolism: A multicountry, population-based cohort and nested case-control study

PLoS Neglected Tropical Diseases Nov 21, 2019

Fitzpatrick KE, van den Akker T, Bloemenkamp KWM, et al. - Data from multiple countries was pooled to define risk factors, management, and outcomes of amniotic fluid embolism (AFE). In addition, researchers examined how the findings are affected when the United Kingdom, international, and United States AFE case definitions are considered. They studied data on women with AFE (n = 99–218 depending on case definition) from five high-income countries as well as analyzed data on a sample of control women without AFE (n = 4,938) collected in two of the countries. Depending on the definition of AFE used, it was noted that AFE affects between 1 in every 125,000 to 1 in every 55,000 women giving birth. Death or a permanent neurological injury occurs in 30%–41% of women suffering from the condition. When different case definitions were applied, similar findings were observed concerning factors linked with the occurrence of AFE and factors linked with poor maternal outcomes amongst women with AFE. Poor maternal outcomes were reported in correlation to less likelihood of receiving interventions such as platelets to correct blood clotting problems, a lower dose of tranexamic acid, and less likelihood of having an obstetrician and/or anaesthetist present at the time of the AFE event.
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