Former Oregon State gymnast, Hailey Okula age 33, an ER Nurse and a popular nurse influencer (with the handle @RNNewgrads) tragically died during childbirth. She had shared her fertility struggles and her audience was happy when she announced her pregnancy. Last week, she went into labor, and her husband later posted that she had died during childbirth.
Hailey had an amniotic fluid embolism. This condition involves fetal cells in the amniotic fluid entering the maternal blood supply and traveling to the lungs. It causes symptoms similar to an anaphylactic reaction, with blood vessels and airways tightening. The inflammatory response activates coagulation, leading to disseminated intravascular coagulation (DIC). DIC causes excessive clotting, which depletes clotting factors and results in spontaneous bleeding (counterintuitively causing clotting and bleeding at the same time). This condition can be fatal within an hour.
Risk factors for amniotic fluid embolism include multiple pregnancies, advanced maternal age (over 35), and conditions like placenta accreta, where the placenta grows into the uterus. Hailey had a history of IVF, which is associated with 8% of amniotic fluid embolism cases. However, many women with these risk factors do not develop the condition.
Approximately 1,000 women die during childbirth each year in the United States, and amniotic fluid embolism is not the leading cause. Symptoms can be sudden and severe, including shortness of breath, low blood pressure, abnormal heart rate, fetal distress, and potentially cardiac arrest . It is important for doctors to recognize these symptoms quickly, although they can overlap with other conditions.
Pregnancy is not a benign condition; it puts significant strain on the body, including immunosuppression and increased blood volume. Despite the risks, the number of deaths is relatively low compared to the millions of childbearing women.
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