Septic Shock Resulting in Death After Operative Delivery

[摘要] Background:We report a youngwoman who developed septic shock after operative delivery in the 32nd week ofpregnancy.Clinical features, treatment modalities and prognosis of this high-mortality-rate disorder are presentedand discussed.Case:A 24-year-old woman, gravida 1, para 1, was referred to our clinic in a confused state and immediatelyadmitted to our emergency unit. She apparently had eclampsia antenatally. Termination of pregnancy withinduction of labor and vacuum extraction had been employed in gestational week 32 of pregnancy. One day afterdelivery, her clinical and laboratory parameters worsened, so she was referred to our clinic. After a thoroughphysical examination and laboratory evaluation, the patient was diagnosed as having sepsis and disseminatedintravascular coagulation. After blood and urine cultures were taken, aggressive management included volumerepletion, antibiotics and positive inotropic therapy. Because she had persistent fever and unimproved laboratoryvalues despite these therapies, the uterus and ovaries were thought to be the source of sepsis, and total abdominalhysterectomy and bilateral salpingo-oophorectomy were performed. Neither clinical nor laboratory parametersimproved, and the patient died 28 days after delivery as a result of respiratory failure.Conclusion:It is our purpose to emphasize that a rapid and appropriate decision for surgery may prevent thematernal mortality in obstetric septic shock patients. Successful management depends on early identification andaggressive treatment.

[学科分类] 妇产科学