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AFE UK Mortality Rate — FRCA Final MCQ

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HardObstetric AnaesthesiaAFE UK Mortality RateFRCA Final

A 28-year-old woman (ASA I) at 34 weeks gestation develops sudden onset dyspnoea, cyanosis, and altered consciousness during labour. She becomes hypotensive and develops DIC. Fetal monitoring shows decelerations. The obstetrician suspects amniotic fluid embolism. According to the UKOSS data, what is the mortality rate of amniotic fluid embolism in the UK?

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Correct answer: B — 19-20%

UK Obstetric Surveillance System (UKOSS) data reports AFE mortality of approximately 19-20% in the UK, which is lower than historical estimates (up to 60-80%). Survival has improved with: early recognition, aggressive supportive care (intubation, vasopressors, blood product replacement for DIC), point-of-care coagulation testing (TEG/ROTEM), and multidisciplinary critical care. AFE is a diagnosis of exclusion. The Clark model suggests it is an anaphylactoid reaction to amniotic fluid components rather than a mechanical embolic event.

Reference: RCOG – 2022 – AFE management; UKOSS – 2020 – AFE UK data