Passage of amniotic fluid, fetal cells, and debris into maternal circulation

Activation of immunologic and humoral inflammatory cascade

Vasoconstriction of pulmonary vessels

RV dilatation as a result of increased afterload → RV dilatation → RV failure → septum deviation towards LV → decreased LV volume with increased end-diastolic pressure and decreased cardiac output → severe hypotension and hypoxemia → cardiac arrest

If patient survived initial insult

Dilatation of right side persists → septal deviation towards LV persists → elevated filling pressures of the heart with decreased LV volume → pulmonary edema and decreased cardiac output

– Hypoxemia

– Fetal heart deceleration

– Hypoxic ischemic encephalopathy

– Hypotension and cardiac arrest

– DIC and bleeding

– Hypoxic ischemic encephalopathy