What is Amniotic Fluid Embolism?

Pregnancy and childbirth are incredible moments in a woman's life, but they also come with their share of risks. One such risk that concerns both expectant mothers and healthcare providers is Amniotic Fluid Embolism (AFE).

AFE is a rare but potentially life-threatening condition that can occur during pregnancy, labour, or shortly after childbirth. AFE can result in lung failure or heart failure, causing several complications due to the lack of oxygenated blood in the body. The condition is unpredictable and challenging to treat, requiring immediate medical attention.

In this blog post, we will delve into the depths of Amniotic Fluid Embolism, discussing its causes, symptoms, and the crucial importance of monitoring maternal and fetal health. We'll also introduce you to groundbreaking technology, Janitri's Keyar DT Lite, wireless fetal monitoring using a smartphone, which plays a pivotal role in detecting and managing AFE, along with its broader applications in improving maternal and fetal health.

Understanding Amniotic Fluid Embolism (AFE)

Amniotic Fluid Embolism is one catastrophic complication where amniotic fluid, hair, fetal cells, or other debris enters into the maternal bloodstream, triggering a severe allergic reaction such as cardiovascular failure. It may occur in healthy women during labour, during the second trimester, after abnormal vaginal delivery, during caesarean section, or can happen up to 48 hours post-delivery.

Causes and Risk Factors Associated with AFE

AFE is a rare complication, and the cause is unknown. The breaking down of the placenta during delivery or labour may trigger an immune response in women, resulting in AFE. AFE can also occur during amnioinfusion and abortion or after abdominal trauma. Current research into AFE includes the following risk factors:

• Older maternal age

• Intense contractions during labour

• Early separation of the placenta from the uterine wall

• Tears in the cervix or uterus

• Multiple pregnancies

• Eclampsia

• Placenta previa

• Induction of labour

• Caesarean section

• Abdominal trauma

• Multiparity

Some fetal factors include:

• Male baby

• Fetal death

• Fetal distress

Symptoms and Signs of AFE

The symptoms and signs of AFE develop quickly and suddenly, making it challenging to detect the issue. However, possible symptoms include:

• Chills

• Sudden anxiety, confusion, or anxiety

• Fetal distress

• IV sites bleeding, bleeding from the uterus, or C-section incision

Complications and Clinical Presentation 

AFE can result in serious complications for the mother and fetus. It includes:

• Death

• Brain damage

• Cardiac arrest

• Stroke

• Disseminated intravascular coagulation (a blood clotting issue)

• Excessive bleeding

• Seizures

• Loss of consciousness

• Heart and lung failure

Whenever an amniotic fluid embolism occurs, the fetus is at risk of several complications, and an emergency delivery might be necessary before the symptoms begin. Babies born once the AFE symptoms have begun might be at risk of oxygen deficiency, resulting in nervous system or brain impairments.

How do doctors detect amniotic fluid embolism?

Doctors will rule out certain possible causes to diagnose amniotic fluid embolism. It typically occurs within 30 minutes of delivery or in labour. Your doctor may diagnose AFE if they find the following symptoms:

• Excessive bleeding or severe haemorrhage with no explanation

• Irregular heart rate or complete cessation of heartbeats

• Sudden drop in blood pressure

• Difficulty breathing

According to healthcare providers, amniotic fluid embolism is classified into two phases:

Phase 1: Lack of oxygen leads to rapid respiratory failure and cardiac arrest. This phase causes the highest fatalities.

Phase 2: The hemorrhagic phase caused by haemorrhage results in excessive and uncontrolled bleeding from the uterus where the placenta was attached or a C-section incision.

The condition requires immediate treatment, such as.

• Immediate delivery

• A pulmonary artery catheter, a catheter in your arteries helps to monitor blood pressure

• Oxygen by using mechanical ventilation or tracheal tube to help with breathing

• Cardiopulmonary resuscitation

• Hysterectomy to stop bleeding

• Platelet, plasma, or blood transfusions

The Importance of Monitoring Parameters during Pregnancy and Labour

Monitoring vital parameters during pregnancy and labour is crucial for several compelling reasons:

Early Detection of Complications: Continuous monitoring allows healthcare providers to detect potential complications early. Conditions like preeclampsia, gestational diabetes, or amniotic fluid embolism (AFE) may develop without obvious symptoms. Timely identification of these issues can lead to early intervention, reducing the risk of severe complications.

Maternal Health: Monitoring vital parameters such as blood pressure, heart rate, and oxygen saturation helps assess the mother's overall health. Elevated blood pressure or a rapid heart rate may indicate conditions like hypertension or cardiac problems, which can pose risks during pregnancy and labour.

Fetal Well-being: Continuous monitoring also assesses the well-being of the fetus. Tracking parameters like fetal heart rate, contractions, and uterine activity ensures that the baby is receiving an adequate oxygen supply.

Reducing Maternal Mortality: Monitoring vital parameters during pregnancy and labour contributes to the early identification of life-threatening conditions, allowing for timely interventions that can save the mother's life.

Traditional methods and tools for monitoring maternal and fetal health have been essential in obstetric care for many years. While they have proven valuable, they often rely on periodic assessments and may not provide real-time data.

Breakdown of Some Traditional Methods and Why Continuous Monitoring is Increasingly Important

Auscultation:

Traditional Method: Auscultation involves listening to the fetal heart rate (FHR) and maternal heart rate using a handheld Doppler device or a stethoscope.

Limitation: Auscultation is intermittent and may not capture rapid changes in heart rate or other vital signs. It is also subject to human error in counting beats.

Intermittent Electronic Fetal Monitoring (EFM):

Traditional Tool: EFM uses external sensors to monitor FHR and uterine contractions intermittently during specific time intervals, typically during active labour.

Limitation: EFM may miss subtle or rapid changes in fetal well-being between assessment intervals. It can also result in false alarms and increased interventions.

Blood Pressure Measurement:

Traditional Method: Blood pressure is measured intermittently using a sphygmomanometer during prenatal visits and labour.

Limitation: Blood pressure readings at isolated moments may not detect hypertension or hypotension that develops or fluctuates rapidly during labour.

Contraction Monitoring:

Traditional Tool: Uterine contractions are typically monitored externally using a tocodynamometer, which measures changes in uterine pressure.

Limitation: Intermittent monitoring may not accurately represent the frequency and intensity of contractions, potentially missing signs of complications like uterine hyperstimulation.

Clinical Assessments:

Traditional Method: Healthcare providers perform routine clinical assessments during prenatal visits, including physical exams, urine tests, and measuring fundal height.

Limitation: These assessments provide valuable information but may not detect rapid changes or conditions that require continuous observation.

How Janitri's Keyar DT Lite Helps Monitor Important Parameters in AFE?

Janitri's Keyar DT Lite is an NST at-home, portable fetal monitoring device that plays a pivotal role in maternal and fetal health monitoring, especially in the early detection of Amniotic Fluid Embolism (AFE). Here's a closer look at the specific parameters and vital signs that Keyar DT Lite can monitor:

Fetal Heart Rate (FHR): Keyar DT Lite continuously tracks the fetal heart rate, providing real-time data on the baby's cardiac activity. Any deviations from the normal heart rate pattern can be detected promptly.

Maternal Heart Rate (MHR): This monitoring system also keeps a close watch on the maternal heart rate, alerting healthcare providers to any sudden changes that may indicate distress or complications in the mother.

Contractions: Keyar DT Lite monitors uterine contractions, measuring their frequency, duration, and intensity. This data is crucial for assessing the progress of labour and identifying potential issues such as uterine hyperstimulation.

Early Detection of AFE with Keyar DT Lite, Wireless Fetal Monitoring Machine

Now, let's explore how Keyar DT Lite aids in the early detection of Amniotic Fluid Embolism:

Real-time Data: Keyar DT Lite provides healthcare providers with real-time data, allowing them to closely track vital signs without interruption. This constant stream of information ensures that any abrupt changes are immediately flagged.

Pattern Recognition: The system's software can analyse patterns in vital signs and contractions. For example, it can detect sudden decreases in fetal heart rate or erratic contractions, which are potential signs of AFE.

NST at home: Keyar DT Lite offers pregnancy monitoring at home and keeps track of your baby’s well-being. The data collected by Keyar DT Lite can also assist in the diagnostic process. When AFE is suspected, the system's continuous monitoring provides a wealth of information for healthcare providers to make a well-informed diagnosis.

Share Reports: The continuous monitoring data generated by Keyar DT Lite serves as valuable data, both for patient records and potential medical investigations. This aids in post-event analysis and decision-making.

Need for Immediate Action

In conclusion, Amniotic Fluid Embolism (AFE) is a rare but potentially life-threatening complication that can occur during pregnancy, labour, or shortly after childbirth. While the exact cause of AFE remains unknown, its rapid onset and complex clinical presentation make early detection and intervention crucial for improving outcomes.

Awareness of AFE and its risk factors is essential for expectant mothers and healthcare providers alike. Understanding the common symptoms and signs associated with AFE empowers individuals to seek immediate medical attention when necessary.

Continuous monitoring technologies, such as Janitri's Keyar DT Lite, play a pivotal role in maternal and fetal health monitoring. These tools provide real-time data on vital signs, contractions, and fetal heart rate, enabling healthcare providers to detect AFE and other complications promptly.

In the face of AFE, swift action is imperative. Timely intervention can reduce the severity of complications and save lives. By raising awareness, staying vigilant, and embracing innovative monitoring solutions, we can work together to ensure safer pregnancies and childbirths for all."

Frequently Asked Questions

What are the long-term effects of AFE?

The long-term effects depend on the health history and how your body has reacted to AFE. There can be both psychological and physical effects, including:

- Post-traumatic stress disorder

- Anxiety and depression

- Kidney issues

- Stroke complications (if you had a stroke)

- Permanent heart damage

- Neurological damage affecting memory

Can amniotic fluid embolism happen during a C-section?

AFE can occur during a C-section or parturition at the terminal stage of pregnancy. However, it can also take place during cervical suture removal to prevent abortion by incompetent cervix and during curettage and dilatation of missed abortion patients at the second stage of pregnancy.

What are the safety considerations of amniotic fluid embolism?

It is necessary to avoid any trauma to the uterus during manoeuvres, including rupture of membranes or insertion of a pressure catheter. If possible, avoid incision of the placenta during C-section delivery. Keep Janitri Keyar DT Lite NST machine with you to monitor your pregnancy and avoid.

To further your knowledge and take proactive steps towards safer pregnancies and childbirths, consider the following:

If you're expecting or planning to have a baby, or if you're a healthcare professional interested in advanced monitoring solutions, you can learn more about Janitri Keyar DT Lite by visiting our official website or contacting us.

Remember that your health and the health of your baby are paramount, and proactive measures can make a significant difference in ensuring a safe and successful pregnancy and childbirth.