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This chapter discusses the maternal and fetal implications, diagnostic signs, and management strategies for amniotic fluid embolus (AFE). Pulmonary oedema, acute respiratory distress syndrome, disseminated intravascular coagulopathy (DIC), pulmonary embolus, haemorrhage, right then let cardiac failure, cerebrovascular events, cardiorespiratory arrest, death are maternal implications of AFE. The first-line management involves resuscitation strategies. The main aim of early delivery is to facilitate and improve outcome of maternal resuscitation. The second-line management includes diagnosis and supportive care. The purpose of ICU is to monitor observations, maintain haemodynamic instability and reduce iatrogenic and disease complications. Options of treatment include diuretics, inotropes and steroids. Plasma exchange, haemofiltration and extracorporeal membrane oxygenation have been used in treatment. Regular fire drills involving maternal collapse on the labour ward can ensure that a robust system is in place for the acute management of AFE.
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