A woman who died soon after giving birth on Mother’s Day suffered what doctors suspect to be a rare condition known as amniotic fluid embolism.

International research into this condition, which is the leading cause of maternal deaths, shows that it impacts two in every 100,000 births in Europe.

Malta has under 5,000 births a year, which means that it would affect one birth every decade.

Speaking in parliament last Tuesday, Health Minister Jo Etienne Abela said the last recorded case of maternal death was 12 years ago. He did not specify the cause.

The maternal mortality rate in Malta stands at three per 100,000 births – that would mean three deaths every 20 years.

Expressing his condolences to the victim’s family, Abela said the hospital staff were also deeply upset by the loss.

The Sri Lankan woman, aged in her 30s, was under the care of Mater Dei Hospital, where she had undergone IVF treatment.

What is amniotic fluid embolism?

Amniotic fluid embolism (AFE) is a rare and life-threatening complication that occurs when a pregnant woman gets amniotic fluid into her bloodstream just before, during or immediately after childbirth.

Amniotic fluid is the liquid that surrounds the foetus in the woman’s uterus during pregnancy. It’s made mostly of water and contains foetal cells. It is not uncommon that small amounts of amniotic fluid enter the mother’s bloodstream during pregnancy or birth, according to a local medical source.

In most cases nothing happens. But in some rare cases the mother can have a severe allergic response when the amniotic fluid mixes with her blood.

What happens exactly?

Experts say this allergic response can lead to two very serious and life-threatening complications: heart and lung failure and severe internal bleeding.

Heart and lung failure causes breathing problems, irregular heartbeat, seizures and can lead to cardiac arrest. When the heart stops beating it is no longer able to send oxygenated blood to the body. Lack of oxygen to the body can cause organ failure and brain damage.

Bleeding is a normal process of birth. However, in women who experience an AFE, there is excessive bleeding and a condition that can lead to the development of excessive blood clots.

Excessive bleeding and clotting may lead to more serious complications, including stroke, organ failure and, ultimately, heart failure.

The word ‘embolism’ means the blockage of a blood vessel.

Can it be avoided?

Research shows that AFE happens suddenly and, according to the Cleveland Clinic, an academic medical research centre, it is unpredictable.

Because it is so rare, a lot remains unknown about what causes this reaction, according to a local expert.

For this same reason, it is difficult to predict, although research points to a few possible risk factors, including advanced maternal age, expecting multiples and C-sections amongst others.

IVF does not increase risks, a local expert said.

Because AFE is difficult to diagnose and dependent on so many factors, it’s hard to assign a survival rate. International studies vary depending on how the data is collected but the death rate may be as high as 60 per cent.

Can it be treated?

Independently, each of the complications – heart and lung failure and internal bleeding – is extremely serious and life-threatening. Together, they are very challenging to treat and require immediate and aggressive medical care, according to local medical experts.

Treatment of heart and lung failure includes oxygenating the body by placing a breathing tube (intubation), cardiopulmonary resuscitation (CPR) and medications to help manage blood pressure and help the heart beat regularly.

Treatment of haemorrhage include blood transfusions, surgical procedures and medications to help control bleeding and replenish the body’s blood volume.

This article was compiled using information from the Cleveland Clinic, National Organisation or Rare Disorders, the Amniotic Fluid Embolism Foundation as well as local medical experts.