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Amniotic fluid embolism (AFE) remains an enigmatic, but devastating obstetrical condition associated with significant maternal and newborn morbidity and mortality. Although our understanding of this condition is incomplete, research over the past 2 decades has altered traditional concepts of both the causation and pathophysiology of AFE. Although maternal treatment remains primarily supportive, prompt delivery of the fetus can substantially improve neonatal outcome after AFE-induced cardiac arrest. Newer biochemical markers may in the future enhance the specificity and sensitivity of this clinical diagnosis and could potentially lead to improved therapy.