Features in the diagnosis of sepsis in pregnant and parturient women

Ya.M. Pidhirnyi

Abstract


Physiological features of pregnant women make allowances to the classic picture of the diagnosis and treatment of sepsis/septic shock in this category of patients. The objective of this work was to study the features of sepsis and septic shock in pregnant and parturient women, taking into account the Surviving Sepsis: International Guidelines for Management of Sepsis and Septic Shock: 2012–2016 protocol. The problem of sepsis remains very acute in our time, including in obstetrics. Today in the world, infections rank third in the structure of maternal mortality and constitute about 15 %. The article discusses the results of the diagnosis and treatment of 37 pregnant/parturient women with sepsis, which appeared due to peritonitis on the background of chorimanionitis and postpartum endometritis. Patients were treated in the clinic of anesthesiology and intensive care of the Lviv Regional Hospital from 2010 to 2016. All patients underwent intensive therapy (volemic resuscitation, cardiorespiratory support, antibacterial therapy) and surgical intervention (elimination of peritonitis, sanitation and drainage of the abdominal cavity). The general state of the patients was assessed at 14.5 ± 1.5 points on the АРАСНЕ II scale, and the state of multi-organ dysfunction was 5.0 ± 1.0 points on the SOFA scale.


Keywords


sepsis; septic shock; pregnancy

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DOI: https://doi.org/10.22141/2224-0586.3.82.2017.102322

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