Billinson: gives birth in critical condition due to amniotic fluid embolism

Tragedy at Billinson Medical Center: In the last few hours, during a quiet birth, a woman giving birth at 35 weeks developed a suspicion of an embolic event, a life-threatening event, which required life-saving intervention, including connection to a heart-lung machine. The woman in her 30s is in critical condition and many teams are fighting for her life. The incident was reported to Klalit Health Services and the Ministry of Health.

Amniotic fluid embolism is an extremely rare complication of childbirth, occurring in approximately one in 20,000 to 80,000 births. This is an emergency medical condition in which particles from the amniotic fluid, which include fetal skin cells, hair or other cells, enter the mother’s bloodstream during or after birth. This penetration causes the mother’s immune system to react in an extreme way, which leads to an “anaphylactic shock”-like reaction, which is a life-threatening allergic reaction that involves different systems in the body, and which poses a serious threat to her life.

Although studies have been conducted on embolism over the years, the medical world still does not know with certainty what the exact reason for its occurrence is or which women are at risk of developing it. However, it is known that these cases usually occur in the advanced stages of childbirth, or immediately after it.

Amniotic fluid embolism is a condition that is difficult to diagnose immediately due to the rapid onset of symptoms and their severity. In most cases, symptoms include sudden systemic collapse, cardiac arrest, severe shortness of breath, and coagulation system dysfunction leading to severe bleeding. Some women also develop acute breathing problems, extremely low blood pressure (shock), and sometimes death within minutes.

The diagnosis is mainly based on the identification of the clinical signs and the history of the birth process, and this is because there is no clear and immediate test that can confirm an amniotic fluid embolism in real time.

The treatment of amniotic fluid embolism is an emergency treatment and requires a quick response from the medical team. It includes giving the patient oxygen, fluid infusion to improve circulatory function, and often blood transfusion in cases of severe bleeding. In more difficult situations, as in the current case in Billinson, the use of an ECMO machine is required to replace the heart and lungs and help restore the body’s function.

In recent years, in advanced medical centers with trained emergency teams, mortality rates have dropped to about 25%. This is compared to the past, when the mortality rate was about 80%. However, in many cases brain damage is caused due to the lack of oxygen supply to the brain cells during the collapse of the systems.

The prognosis and prediction of amniotic fluid embolism remains difficult, despite advances in treatment. Even women who survive the condition are sometimes at risk of irreversible damage such as brain damage, hysterectomy due to heavy bleeding, and other neurological disorders. Maternal death may occur within minutes of the onset of symptoms, which emphasizes the need for the availability of skilled medical personnel in hospitals.

As of today, there is no way to predict which woman may develop an amniotic fluid embolism, and there is no way to prevent the phenomenon. Healthy women with no known risk factors can experience this embolism without any warning, and this is one of the great challenges of the medical world in understanding embolism.