Amniotic fluid embolism: analysis of the national registry

Am J Obstet Gynecol. 1995 Apr;172(4 Pt 1):1158-67; discussion 1167-9. doi: 10.1016/0002-9378(95)91474-9.


Objective: We analyzed the clinical course and investigated possible pathophysiologic mechanisms of amniotic fluid embolism.

Study design: We carried out a retrospective review of medical records. Forty-six charts were analyzed for 121 separate clinical variables.

Results: Amniotic fluid embolism occurred during labor in 70% of the women, after vaginal delivery in 11%, and during cesarean section after delivery of the infant in 19%. No correlation was seen with prolonged labor or oxytocin use. A significant relation was seen between amniotic fluid embolism and male fetal sex. Forty-one percent of patients gave a history of allergy or atopy. Maternal mortality was 61%, with neurologically intact survival seen in 15% of women. Of fetuses in utero at the time of the event, only 39% survived. Clinical and hemodynamic manifestations were similar to those manifest in anaphylaxis and septic shock.

Conclusions: Intact maternal or fetal survival with amniotic fluid embolism is rare. The striking similarities between clinical and hemodynamic findings in amniotic fluid embolism and both anaphylaxis and septic shock suggest a common pathophysiologic mechanism for all these conditions. Thus the term amniotic fluid embolism appears to be a misnomer.

MeSH terms

  • Adolescent
  • Adult
  • Anaphylaxis / physiopathology
  • Chi-Square Distribution
  • Embolism, Amniotic Fluid / complications
  • Embolism, Amniotic Fluid / mortality
  • Embolism, Amniotic Fluid / physiopathology*
  • Female
  • Fetal Death / epidemiology
  • Fetal Death / etiology
  • Fetus
  • Heart Rate, Fetal
  • Humans
  • Hypersensitivity / complications
  • Male
  • Obstetric Labor Complications / physiopathology
  • Oxytocin / therapeutic use
  • Pregnancy
  • Prognosis
  • Puerperal Disorders / physiopathology
  • Registries*
  • Retrospective Studies
  • Sex Factors
  • Shock, Septic / physiopathology
  • Survival Rate
  • United States


  • Oxytocin