Amniotic fluid embolism (AFE) although rare carries a high risk of severe morbidity and death, a study from Australia has confirmed. Maternity data were assessed over seven years in a cohort of 606,393 deliveries in New South Wales. Twenty cases of AFE were identified giving an incidence of 3.3 per 100,000 deliveries. All were in singleton pregnancies, 79% were in multiparous women. Seven women died; a case fatality rate of 35%. In the six women who died in hospital the perinatal death rate (stillbirths + neonatal deaths) was 50%. Perinatal mortality where the mother survived was 23%. 'I found this study of interest not just because it served as a useful reminder of the condition but also its demographic and delivery associations. Survival appeared strongly linked to rapid high-tech intensivist intervention.'