Doctors stress awareness of this unpredictable condition that can cause sudden maternal collapse.
Hyderabad: Childbirth is often described as a beautiful and life-changing experience, but there are certain conditions that expectant mothers need to know about childbirth. There are some extremely rare yet life-threatening conditions that can prove to be fatal for mothers. One such condition is known as an Amniotic Fluid Embolism (AFE). Though highly uncommon, AFE can occur suddenly during labour or shortly after delivery, posing severe risks to both mother and baby.
Dr Anisha Gala Shah, senior consultant in obstetrics, explained, “AFE happens when amniotic fluid, which normally surrounds and protects the baby, enters the mother’s bloodstream. This triggers a severe allergic reaction that can affect multiple organ systems, including the heart, lungs, kidneys, and blood clotting mechanisms.”
AFE is estimated to occur in 1 in 8,000 to 1 in 80,000 births, though precise statistics for India remain unclear due to the difficulty in diagnosing the condition without an autopsy. “The symptoms mimic other life-threatening conditions and develop rapidly, leaving little time for diagnosis or intervention,” said Dr Shah.
"Amniotic fluid embolism is an extremely rare and often fatal condition that can occur in pregnant women, usually around the time of delivery. It happens when amniotic fluid or fetal tissue enters the mother’s bloodstream, typically through open blood vessels during a C-section or a normal delivery. This triggers a severe immune response, like an acute allergic reaction, leading to sudden cardiovascular collapse. Many times, it’s a diagnosis of exclusion, made retrospectively after ruling out other causes. Unfortunately, it's almost impossible to predict or prevent, and unless immediate, advanced ICU support is available, the chances of revival are slim," said Dr Vasundara Cheepurupalli, Senior Consultant Gynaecologist.
While the exact cause of AFE remains unknown, certain factors may increase the risk. These include multiple pregnancies (twins, triplets, etc), advanced maternal age (over 35 years), fetal distress, excess amniotic fluid (polyhydramnios), labour induction, and complications like forceps-assisted deliveries or caesarean sections.
The symptoms of AFE can escalate quickly, including sudden breathlessness, loss of consciousness, low blood pressure, rapid heart rate, cold and clammy extremities, excessive bleeding, and agitation. In cases where the mother succumbs, an autopsy often reveals amniotic fluid in the lungs.
“AFE is a rapidly deteriorating condition,” warned Dr Andal Reddy, Senior Consultant Obstetrician & Gynaecologist. “There’s hardly any time to act, which makes prompt recognition and immediate medical intervention critical.”
Treatment typically involves supportive measures such as urgent delivery of the baby, blood transfusions, ventilatory support, and in severe cases, hysterectomy (removal of the uterus) to control bleeding. A multidisciplinary approach with well-equipped facilities significantly improves survival chances.
Despite advancements in medical care, AFE remains a leading cause of maternal mortality worldwide. “We need to focus on raising awareness, early recognition, and ensuring that intensive care services are available even in remote areas,” Dr Reddy said.
As Hyderabad continues to grow, healthcare professionals urge expectant mothers and families to be informed about this rare condition. “While AFE cannot always be prevented, understanding the risks and early signs can make a critical difference,” said Dr Shah.
