Kramer et al (2006) carried out a cohort study of
3 million hospital deliveries in Canada between 1991
and 2002 to assess the association between overall
and fatal rates of amniotic fluid embolism and
medical or surgical induction of labour, maternal
age, fetal presentation, mode of delivery and pregnancy
and/or labour complications. It was found
that the rate of amniotic fluid embolism was 14.8 in
100 000 multiple births and 6 in 100 000 singleton
births. Of the 180 cases of amniotic fluid embolism
in singleton pregnancies, 24 were fatal. It was found
that medical induction nearly doubled the risk of
amniotic fluid embolism, and the authors recommended
that elective induction of labour should
be considered carefully in cases where women have
predisposing risk factors.