medigraphic.com
ISSN 2448-8909 (Print)

2016, Number 3

<< Back Next >>

Med Crit 2016; 30 (3)

Recognizing sepsis as a direct cause of maternal death in Obstetrical Intensive Care Unit

Álvarez-Goris MP, Sánchez ZR, Torres AAA, Pérez CÁA, Briones GJC, Sarmiento ÁJ

Language: Spanish
References: 22
Page: 178-182
PDF size: 162.16 Kb.


ABSTRACT

Sepsis in Mexico is one of the 10 leading causes of direct maternal death. Obstetric patients represent a challenge under their, physiological changes and sepsis is certainly a challenger pathology to diagnosis and treatment. It’s an important cause of admission to intensive care units (ICU) and the leading cause of death in the developed world.
Methods: A retrospective, observational study of sepsis in the ICU Obstetric entered in the overall reporting of maternal deaths, from January 2005 to March 2015, 86 were excluded and included 19 patients. Variables were analyzed: age, source of infection, obstetrical period, affected organs and systems and literature review was made.
Results: Sepsis accounted for 18 % (n = 19) of total maternal deaths. Age range: 16-38 years (mean: 24.2 standard deviation ± 6.1). Prevalence: postpartum period: 47.4 % (n = 9), pregnancy or childbirth 36.8 % (n = 7) and abortions 15.8% (n = 3). System and/or affected organs: gastrointestinal 42.1 % (n = 8); pulmonary 21.1% (n = 4); vascular and hematological: 21.1% (n = 4); cardiovascular, cerebral and renal 5.3% (n = 1).
Conclusion: The objective analysis of the characteristics of patients , obstetric etiology associated state and will give us the tools to recognize and attack the enemy, the early onset of aggressive resuscitation by the obstetrician impact on patient survival.


REFERENCES

  1. Freyermuth G, Luna M, Muños JA. Observatorio de mortalidad materna en México. Indicadores 2013. Objetivos de desarrollo del Milenio 5: Avances en México. 2015.

  2. Briones GJ, Sosa GO, Arias DC, Briones VC. Muerte materna por sepsis. En: Briones G, Díaz de LPM. Mortalidad materna: México. Editorial Alfil; 2013, pp. 51-52.

  3. Sheffield JS. Sepsis and septic shock in pregnancy. Crit Care Clin. 2004;20(4):651-660.

  4. Barton JR, Sibai BM. Severe sepsis and septic shock in pregnancy. Obstet Gynecol. 2012;120(3):689-706.

  5. Cordioli RL, Cordioli E, Negrini R, Silva E. Sepsis and pregnancy: do we know how to treat this situation? Rev Bras Ter Intensiva. 2013;25(4):334-344.

  6. Snyder CC, Barton JR, Habli M, Sibai BM. Severe sepsis and septic shock in pregnancy: indications for delivery and maternal and perinatal outcomes. J Matern Fetal Neonatal Med. 2013;26(5):503-506.

  7. Albright CM, Ali TN, Lopes V, Rouse DJ4, Anderson BL. The Sepsis in Obstetrics Score: a model to identify risk of morbidity from sepsis in pregnancy. Am J Obstet Gynecol. 2014;211(1):39.e1-8.

  8. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-1554.

  9. Bamfo JE. Managing the risks of sepsis in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013;27(4):583-595.

  10. Timezguid N, Das V, Hamdi A, Ciroldi M, Sfoggia-Besserat D, Chelha R, et al. Maternal sepsis during pregnancy or the postpartum period requiring intensive care admission. Int J Obstet Anesth. 2012;21(1):51-55.

  11. Lapinsky SE. Obstetric infections. Crit Care Clin. 2013;29(3):509-520.

  12. Lucas DN, Robinson PN, Nel MR. Sepsis in obstetrics and the role of the anaesthetist. Int J Obstet Anesth. 2012;21(1):56-67.

  13. Mor G, Cardenas I, Abrahams V, Guller S. Inflammation and pregnancy: the role of the immune system at the implantation site. Ann N Y Acad Sci. 2011;1221:80-87.

  14. Nares-Torices M, Hernández-Pacheco JA, Estrada-Altamirano A, Lomelí-Terán JM, Mendoza-Calderón SA, Flores-Cortés MI, et al. Manejo de sepsis y choque séptico en el embarazo. Perinatol Reprod Hum. 2013;27(4):248-261.

  15. Figueroa DR, Hernández PJA. Choque séptico en obstetricia. En: Hernández PJA, Estrada A. Medicina Crítica y Terapia Intensiva en Obstetricia. México, D.F. Intersistemas editores. 2007, pp. 201-208.

  16. Morgan J, Roberts S. Maternal sepsis. Obstet Gynecol Clin N Am. 2013;40:69-87.

  17. Pacheco LD, Saade GR, Hankins GDV. Severe sepsis during pregnancy. Clin Obstet Gynecol. 2014;57(4):827-834.

  18. Arulkumaran N, Singer M. Puerperal sepsis. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):893-902.

  19. Miskin A, Kumar A, Gokhale L. Reducing sepsis in obstetrics-developing an obstetric sepsis care bundle! Int J Gynaecol Obstet. 2012;119(3):835-836.

  20. Fischerova D. Urgent care in gynaecology: resuscitation and management of sepsis and acute blood loss. Best Pract Res Clin Obstet Gynaecol. 2009;23(5):679-690.

  21. Dellinger RP, Levy MM, Carlet JM, et al. surviving sepsis guidelines: international guidelines for management of severe sepsis and septic shock. Intensive Care Med. 2008;34:17-60.

  22. Mazuski JE. Antimicrobial treatment for intra-abdominal infections. Expert Opin Pharmacother. 2007;8:2933-2945.




2020     |     www.medigraphic.com