Doctor explains - After the death of a TikTok star: What makes fruit water emboli dangerous
## Table of Contents
- How does a Water Amniotic Embolism occur?
- What happens to the foreign material in the mother's bloodstream?
- How does it affect the baby?
- What are the risk factors for a Water Amniotic Embolism?
- What are the symptoms of a Water Amniotic Embolism?
- How is a Water Amniotic Embolism treated?
Water Amniotic Embolism, fortunately, is a rare occurrence where the mother's heart and circulatory system fail during or shortly after childbirth. "Since this emergency cannot be anticipated, help often comes too late if intensive care is not immediately available," says Wolfgang Paulus from the Women's Clinic and Obstetrics of Ulm University. In smaller institutions, only one or two cases occur per decade, according to the specialist in Obstetrics and Perinatal Medicine, who adds: "Even in our University Hospital, such an event commands great respect!"
How does a Water Amniotic Embolism occur?
The exact mechanisms are not yet clear. "Despite its name, the condition probably has no direct relationship to the amount of amniotic fluid that has passed or an embolism, which is a sudden blockage of a blood vessel," says Paulus. It is believed that the Water Amniotic Embolism is a pathological maternal reaction to foreign material such as placental tissue, amniotic fluid, and fetal cells that enter the maternal circulation when vessels in the uterus rupture during childbirth.
What happens to the foreign material in the mother's bloodstream?
The body releases inflammatory mediators, leading to a cascade of bodily reactions: The function of the heart, circulation, and lungs is restricted. The lungs cannot absorb oxygen anymore, the heart does not pump properly, causing the organs to receive insufficient oxygen and nutrients. The lung vessels constrict; through increased resistance, the blood pressure drops. Additionally, the coagulation system is activated fatally. On the one hand, clots block the vessels; on the other hand, bleeding, such as birth injuries, cannot be stopped.
How does it affect the baby?
The unborn child is also at risk. Due to the failure of the maternal heart-circulatory system, it is not adequately supplied. An emergency cesarean section may be necessary, and the child may need to be resuscitated. The child's ability to overcome this dramatic event depends on how long it was deprived of oxygen and how quickly it received intensive medical care.
What are the risk factors for a Water Amniotic Embolism?
The causes are not yet fully understood, but some risk factors are known:
- advanced maternal age
- multiple pregnancies
- complications with the placenta, such as when it is located near the cervix or deeply embedded in the uterine wall
- strong or rapid contractions
- cesarean sections, forceps or vacuum extractions
- excessive amniotic fluid
What are the symptoms of a Water Amniotic Embolism?
The initial symptoms result from the maternal oxygen deficiency and heart problems:
- sudden shortness of breath due to constricted lung vessels and impaired lung function
- blood pressure drop, leading to circulatory shock
- bluish skin and lips due to oxygen deprivation
- chest pain or discomfort in the breast due to the heart's oxygen deficiency
- heart failure.
"The symptoms usually appear suddenly.
How to treat a rupture of membranes?
"We are dealing with a very difficult-to-treat medical condition," says expert Paulus on the subject. In any case, a rupture of membranes is a medical emergency that requires mother and child to receive intensive treatment: breathing support, medications that support the circulation, as well as clotting factors and blood transfusions. The prognosis for the course of the emergency depends on how quickly the rupture of membranes is recognized and treated. However, the possibilities of modern medicine do not suffice in many cases."
The mother might turn to platforms like TikTok for relaxation and distraction during her pregnancy, finding comfort in Tod's soothing videos. Despite the hospital's limited resources, the mother's concerned partner could reach out to their mother or other family members via a phone call, seeking advice or emotional support.
