Frequencies of the main presenting signs and symptoms of AFE reported in large case series
are summarized in the supplementary appendix available online. It should be emphasized
that this information could be affected by underreporting of signs and symptoms in clinical
records. The most common presenting signs and symptoms included hypotension,
respiratory distress, and cyanosis, which were detected in up to 100% of women, DIC in
approximately 50% (range, 22–83%), and seizures in about 20% (range, 10–48%). The
percentage of patients experiencing cardiac arrest and dyspnea varied between 30–87% and
48–72%, respectively. Fetal distress was diagnosed in 50–100% of cases. Cases of AFE with
atypical presentations, in which coagulopathy43,103–105 or severe fetal bradycardia106,107 are
the initial or even the only presenting feature have been reported in the literature. Maternal
death due to AFE is typically caused by sudden cardiac arrest, hemorrhage from
coagulopathy or the development of acute respiratory distress syndrome and/or multisystem
organ failure after initial survival of the acute event.