Amniotic Fluid Embolism

There are a few things in medicine that are as frightening as amniotic fluid embolism (AFE). This can occur at any time during labor and delivery, although most commonly during placental manipulation. AFE is when a collection of amniotic fluid enters the bloodstream and travels into the right ventricle and pulmonary arteries, causing a systemic inflammatory response that results in profound hemodynamic collapse within moments. Rapid diagnosis and supportive treatment may help to decrease maternal morbidity and mortality, but unfortunately, there are no reported treatment methodologies with guaranteed effectiveness. This chapter will review the signs and symptoms of an AFEand risk factors for occurrence and discuss intraoperative management. In addition, this comprehensive chapter contains the materials needed to develop and implement a successful simulation including a case scenario, narrative, and progression as well as a scoring rubric for evaluation of perioperative AFE management.