It is important to note that these figures are quite rubbery. Definitive diagnosis is at present by post-mortem examination which makes the diagnosis difficult in the milder cases. The clinical presentation of AFE is generally dramatic, with the abrupt onset of dyspnoea and hypotension with rapid progression to cardiopulmonary arrest. Evidence of CNS hypoxia is present, with alterations in mental status progressing to coma. These dramatic features may be heralded by patient's non-specific symptoms of shivering, anxiety, cough, vomiting and the sensation of a bad taste in their mouths.
Foetal distress is often present.
However, this is one disease where I thought that the more I read about it the less I knew. Although the classic presentation has always been an elderly, in obstetric terms, multiparous woman with a large baby experiencing a short tumultuous labour associated with the use of uterine stimulants, this is hardly common. Some of the following cases may demonstrate the unpredictable nature of this condition. The concept of increased pressure gradient has been shown to be a problem with the injection of saline to induce abortion when the foetus is dead. However, AFE can occur before, during and after delivery.