see also: [[Fat embolism]], [[Pulmonary Embolism]]
- onset usually during labour and delivery or immediatly postpartium
- non-specific symptoms; chills, nausea, vomiting, agitation
- hypotension due to cardiogenic shock
- hypoxemia and resp failure
- DIC
- coma or seizures
> suspect in labour, delivery, or immediate post-partum setting (within 48 hours) when there is sudden onset of unexplained shock and/or respiratory compromise
**DDx:**
- PE
- Air embolism
- haemorrhage
- eclampsia
- MI
- anaphylaxis
- aspiration
- cardiomyopathy
# treatment
- supportive
# pathophysiology
also known as "anaphylactoid syndrome of pregnancy"
occurs when some antiotic fluid gains access to maternal circulation (via endocervical veins, placental insertion site, or uterine injury eg during c-section) in large volumes with catastropic consequences. it is a slimy, yellowish white and contains mucous which is essentially equivalent ot IV injection of sewer water. **death occurs due to circulatory collapse or resp failure and severe hypoxia.**
hypoxia is due to crude effects of V/Q mismatch when amniotic fluid emboli clog the lungs (kinda like a PE), cardiogenic pulm oedema, non-cardiogenic cap leak pulm oedema, and bronchospasm similar to anaphylaxis.
shock is initially obstruction, and eventially becomes distributive with sepsis-like capillary leak.
eventually get DIC from systemic inflammatory response.
agitaiton, deliriuj, seizures, and coma due to severe hypoxia