Surreal illustration of amniotic fluid embolism diagnostic criteria.

Amniotic Fluid Embolism: New Diagnostic Criteria Could Save Lives

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Groundbreaking research proposes unified diagnostic criteria for amniotic fluid embolism, paving the way for earlier detection and better patient outcomes."

Amniotic fluid embolism (AFE) is a rare and dreaded complication of pregnancy, often striking without warning and carrying a high risk of mortality. Imagine the peace and excitement of childbirth turning suddenly into a life-threatening crisis – this is the reality of AFE. Historically, the diagnosis of AFE has been challenging, relying on a constellation of symptoms and often made after excluding other possible causes.

The lack of clear diagnostic criteria has been a major obstacle in understanding and effectively managing AFE. Different reports have used varying criteria, leading to potential misdiagnoses and making it difficult to compare data across studies. This ambiguity has also hindered research efforts to identify risk factors and develop targeted treatments.

Now, groundbreaking research is offering new hope. A collaborative effort by leading experts has resulted in proposed diagnostic criteria designed to provide a more consistent and accurate approach to identifying AFE cases. This article explores these new criteria, their potential impact, and what they could mean for the future of maternal care.

Unveiling the Proposed Diagnostic Criteria for AFE

Surreal illustration of amniotic fluid embolism diagnostic criteria.

The Society for Maternal-Fetal Medicine and the Amniotic Fluid Embolism Foundation assembled a team of experts spanning critical care obstetrics, maternal-fetal medicine, pulmonary/critical care, anesthesiology, and hematology. Their mission was to develop uniform clinical criteria for research reporting of AFE. The newly proposed diagnostic criteria focus on key signs and symptoms, lab results, and timing of events.

To meet the proposed diagnostic criteria for AFE in a research setting, a patient must exhibit the following:

Sudden onset of cardiorespiratory arrest or respiratory compromise: This includes symptoms like cyanosis (bluish skin), dyspnea (shortness of breath), or a peripheral capillary oxygen saturation (SpO2) below 90%. Hypotension (systolic blood pressure less than 90 mm Hg) must also be present.
Evidence of overt disseminated intravascular coagulation (DIC): This serious condition affects the blood's ability to clot. DIC must be confirmed using the Scientific and Standardization Committee criteria, modified for pregnancy. This involves specific lab values such as a low platelet count, prolonged prothrombin time or international normalization ratio, and low fibrinogen level. Crucially, the coagulopathy must be detected before significant blood loss could skew the results.
Onset during labor or within 30 minutes of delivery: The event must occur during labor or within a short window after delivery of the placenta.
Absence of fever: Fever (above 38.0°C) during labor excludes AFE as a diagnosis.

These criteria are designed to exclude conditions that can mimic AFE, such as hypovolemic shock from postpartum hemorrhage, anesthetic accidents, pulmonary thromboembolism, septic shock, and anaphylactic shock. By carefully defining AFE, researchers hope to better understand this rare but devastating condition.

The Road Ahead: Improving AFE Management and Prevention

The development of these diagnostic criteria is a significant step forward in the fight against AFE. While primarily intended for research purposes, these criteria can also inform clinical practice. By utilizing these criteria, healthcare professionals can improve the accuracy of AFE diagnosis, leading to earlier intervention and potentially better outcomes for affected women and their babies. Future research, guided by these unified criteria, promises to unlock the mysteries of AFE and pave the way for effective prevention strategies.

About this Article -

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Everything You Need To Know

What is Amniotic Fluid Embolism (AFE), and why has it been so challenging to diagnose effectively?

Amniotic Fluid Embolism (AFE) is a rare and life-threatening complication of pregnancy, often occurring unexpectedly during labor or shortly after delivery. Diagnosing AFE has been difficult because it relies on recognizing a combination of symptoms and excluding other possible causes, rather than having clear, standardized diagnostic criteria. This ambiguity has hindered understanding the condition and comparing data across different studies, thus impacting research efforts to identify risk factors and develop targeted treatments.

What are the key components of the newly proposed diagnostic criteria for Amniotic Fluid Embolism (AFE), and what symptoms are considered?

The newly proposed diagnostic criteria for Amniotic Fluid Embolism (AFE) focus on key signs and symptoms, lab results, and the timing of events. To meet the criteria, a patient must exhibit a sudden onset of cardiorespiratory arrest or respiratory compromise, including symptoms like cyanosis, dyspnea, or a peripheral capillary oxygen saturation (SpO2) below 90%, along with hypotension. Evidence of overt disseminated intravascular coagulation (DIC), confirmed using the Scientific and Standardization Committee criteria modified for pregnancy, is also required. The event must occur during labor or within 30 minutes of delivery, and fever must be absent.

How does the presence or absence of fever impact an Amniotic Fluid Embolism (AFE) diagnosis according to the new criteria?

According to the newly proposed diagnostic criteria, the absence of fever is crucial in diagnosing Amniotic Fluid Embolism (AFE). Specifically, a fever above 38.0°C during labor excludes AFE as a diagnosis. This is because fever often indicates other conditions, such as infection, which can mimic some of the symptoms of AFE. By excluding cases with fever, researchers aim to more accurately identify true AFE cases.

What is disseminated intravascular coagulation (DIC), and why is it an important factor in diagnosing Amniotic Fluid Embolism (AFE)?

Disseminated intravascular coagulation (DIC) is a serious condition that affects the blood's ability to clot normally. In the context of Amniotic Fluid Embolism (AFE), DIC is a critical diagnostic factor because AFE can trigger this condition. The diagnostic criteria require evidence of overt DIC, confirmed using specific lab values such as a low platelet count, prolonged prothrombin time or international normalization ratio, and low fibrinogen level, as defined by the Scientific and Standardization Committee criteria, modified for pregnancy. Crucially, the coagulopathy must be detected before significant blood loss could skew the results, ensuring it's a direct result of the AFE and not other factors.

What is the potential impact of adopting these new diagnostic criteria for Amniotic Fluid Embolism (AFE) on research and clinical practice?

Adopting these new diagnostic criteria for Amniotic Fluid Embolism (AFE) has several potential benefits. For research, the unified criteria will enable more consistent and accurate identification of AFE cases, facilitating better data comparison across studies and advancing our understanding of risk factors and potential treatments. In clinical practice, healthcare professionals can use these criteria to improve the accuracy of AFE diagnosis, leading to earlier intervention and potentially better outcomes for affected women and their babies. Though primarily intended for research, these criteria can inform clinical practice, ultimately improving maternal care.