The syndrome of amniotic fluid embolism: a potential contribution of bradykinin.

Abstract

Amniotic fluid embolism is a potentially fatal complication of pregnancy; although several hypotheses have been formulated, the pathophysiology of this condition is not well known. An exaggerated release of bradykinin, which is activated by products of the amniotic fluid that enter the maternal circulation, could explain the symptoms that are present in amniotic fluid embolism. The objective of this study was to assess whether bradykinin is involved in amniotic fluid embolism. The plasma bradykinin-generating capacity was measured serially in a patient who experienced amniotic fluid embolism. The plasma bradykinin-generating capacity was found to be very low at the time of the initial clinical manifestations, which were characterized by severe hypotension, cardiorespiratory arrest, and coagulopathy. This study suggests a potential role for bradykinin release in the pathophysiology of amniotic fluid embolism.