Amniotic fluid embolism

Amniotic fluid embolism (AFE) is a rare but severe complication of pregnancy characterised by a catastrophic systemic dysfunction involving the respiratory, cardiovascular and haematological systems. Its incidence in the UK is approximately 1 in 59,000 maternities, but despite its overall rarity AFE is responsible for a significant proportion of the maternal deaths across the developed world and was the third leading direct cause of maternal deaths ascertained by the UK confidential enquiry 2009-2011. However, it should no longer be considered as resulting in inevitable mortality, and increasing evidence shows that good supportive care can result in improved outcomes for mother and baby. Current data puts case fatality rates for AFE in the UK at around 19%, much lower than previously thought. This review collates the latest literature looking at how and when AFE occurs, its presentation, diagnosis and management.