As reported by Medical News Today, researchers in Canada have concluded that medical induction of labor doubles a woman’s risk for developing amniotic fluid embolism (AFE), a rare but often fatal complication of delivery. AFE occurs when amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, causing cardiopulmonary collapse. Approximately one in five births in the United States involves medical induction, and researchers believe the practice may be responsible for as many as 40 cases of AFE and 15 deaths each year in this country. Labor induction is often medically necessary, such as when the baby is full-term and continuing the pregnancy presents a risk to either mother or baby. However, labor induction is increasingly performed when there is no medical indication, typically for the convenience of either the physician or the parents-to-be.
Michael S. Kramer, M.D., Scientific Director for the Canadian Institutes of Health Research, Institute of Human Development, Child and Youth Health at McGill University, served as lead investigator and cautions that all pregnant women considering elective labor induction should be aware of the risk. “AFE remains a rare occurrence,” said Dr. Kramer. “Of the 180 cases of AFE we found, 24 or 13% were fatal. AFE arose almost twice as frequently in women who had medical induction of labor as in those who did not; fatal cases arose 3½ times more frequently.”
The research team also found several other factors to be associated with higher rates of AFE, including multiple pregnancy, advanced maternal age (35 years or older), caesarean or instrumental vaginal delivery, eclampsia, polyhydramnios (excess amniotic fluid), abnormal placental position or separation, cervical laceration, and uterine rupture.
“Our findings confirm the hypothesis that medical induction of labor is related to an increased risk of AFE,” said Dr. Kramer. “Although the absolute risk increase of AFE for women is very small (four or five total cases and one or two fatal cases per 100,000 women induced) and is unlikely to affect the decision to induce labor in the presence of compelling clinical indications, women and physicians should be aware of this risk if the decision is elective.”
If you or a family member has suffered injuries in connection with obstetrical care under these or similar circumstances, please contact us on-line at Regan Zambri & Long or call us at (202) 463-3030 for a free consultation. If you would like to receive our electronic newsletter, please click here.