Severe sepsis and septic shock in pregnancy and puerperium: an 11-year review in a maternity intensive care unit
© BioMed Central Ltd 2007
Published: 26 September 2007
To estimate the incidence, the etiology and the outcome of severe sepsis and septic shock during pregnancy and puerperium.
Materials and methods
Retrospective collection of data for all obstetric patients with severe sepsis and septic shock admitted to the intensive care unit over an 11-year period (May 1996–May 2007) in a maternity hospital (IASO). Data collected include the characteristics of severe sepsis and septic shock , the source of infection, the responsible infectious organisms, and the outcome.
In the 11-year period, 1,321 women required intensive care unit admission (0.80% of all deliveries) and 52 of them (4%) had severe sepsis or septic shock. The most common infection was chorioamnionitis (23 patients, 41%) and endomyometritis (primarily after cesarean delivery) (11 patients, 21%). Other common infections were septic abortion, pneumonia and pyelonephritis. The most common etiologic agents were Gram-negative rods, followed by Gram-positive bacteria. One patient had fungal (Candida albicans) infection and another Clostridium spp. No deaths were recorded.
Sepsis is an infrequent yet important cause of morbidity and possible death in gravitas. Early recognition of sepsis may prevent maternal complications. The factors that contribute to a decrease rate of severe sepsis, septic shock and death in pregnant women are young age and few comorbid conditions, and the organisms responsible for infections in these women are usually responsive to common broad-spectrum antimicrobial agents.