Amniotic fluid embolism: the complication of known pathomechanism but without pathogenetic therapy?

Thromb Haemost 2009; 101: 795–796 The role of amniotic fluid cells in the initiation of intra vascular coagulation in amniotic fluid embolism is the topic of the article by Zhou et al. (1) in the current issue of Thrombosis and Haemostasis. This is new information which can be considered as an argument for the basic mechanism of amniotic embolism related to disseminated intravascular coagulation/consumption coagulopathy (DIC). This research not only calls for comment itself but also provokes more general remarks on amniotic fluid embolism. Amniotic fluid embolism is among the most dangerous complications of pregnancy, resulting in cardiopulmonary collapse and peritpartal haemorrhage. It is the cause of some 10% of maternal deaths, and it occurs most often during vaginal delivery (70%) or immediately after it (11%), or during caesarean section or soon after it (19%) (2). In as high as 60–80% of cases amniotic fluid embolism results in the death of the mother and baby and, in cases of survival, serious and far-reaching complications have been observed, particularly in children.