科普｜这种疾病在分娩中致死率极高，剖宫和顺产哪个风险更大？

Core Viewpoint - Amniotic fluid embolism (AFE) is unpredictable and lacks screening methods, making preventive measures difficult. In critical situations, the priority is to save the mother, then the child, and finally consider the uterus [1][4]. Group 1: Medical Understanding of AFE - AFE typically occurs during childbirth when components from the amniotic fluid enter the maternal circulation, causing severe immune reactions that can lead to respiratory and cardiac arrest, massive bleeding, and multi-organ failure within minutes [3][4]. - Approximately 70% of AFE cases occur around the time of delivery, particularly within two hours before or half an hour after the fetus is born [3]. - The decision to perform a hysterectomy during AFE management is complex and often necessary to control life-threatening bleeding, especially in cases of disseminated intravascular coagulation (DIC) [3][4]. Group 2: Emergency Response and Treatment - Effective management of AFE relies not only on technical skills but also on timely blood transfusions and multidisciplinary collaboration among experienced medical professionals [4]. - The decision to perform a hysterectomy is a last resort, only considered when other bleeding control methods fail and life-threatening uterine hemorrhage persists [4]. Group 3: Risk Factors and Considerations - The risk of AFE is slightly higher during cesarean sections due to increased surgical manipulation and exposure of blood vessels to amniotic fluid [5]. - Despite the higher risk associated with cesarean delivery, the overall incidence of AFE remains very low, estimated at several thousandths to tens of thousands of a percent in the general population [6].