Amniotic Fluid Embolism:

Latest Concepts and Current Research

This site is intended to provide background on Amniotic Fluid Embolism and give readers information about on-going research about this leading cause of maternal mortality in developed countries.

Photomicrographs

These photographs were taken as part of the research into obstetrical Disseminated Intravascular Coagulation and were presented at the annual meeting of the Society for Gynecologic Investigation in San Diego in 2008.  All of the photos are cross sections of blood vessels in the wall of the maternal uterus removed during emergency surgery to control maternal hemorrhage during childbirth.  These are provided by Michael Kaufman, MD and Robert Goldshmidt, MD, pathologists at NorthShore University HealthSystem.  (The slight blurring is due to loss of definition to reduce file size.)

The photographs below show fetal material in the maternal circulation.  Leakage of large amounts of fetal material has been implicated in AFE although this study raises some doubt about this traditional view. It appears that that these foreign bodies did not necessarily result in an allergic reaction or any injury (although all mothers were experienced life-threatening hemorrhage).  Immunologic communication between mother and fetus, at least at some level, seems to be commonplace.  Any explanation for immune tolerance has to include the mechanism for avoiding allergy to fetal material passing the placental barrier and getting into the maternal circulation at large.

 Photomicrograph 1

 

 Normal uterine wall blood vessel without fetal material.

 Photomicrograph 2 

 

 Uterine wall blood vessel with fetal squames.

 Photomicrograph 3

 

 Uterine wall blood vessel with bile

(derived from fetal meconium [bowel movement] entering the maternal circulation 

 Photomicrograph 4

 

 Uterine wall blood vessel with fetal hair.

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