关键词: 脓毒症, 休克, 脓毒性, 羊膜腔穿刺术, 连续性肾替代疗法, 流产

Abstract:

Obstetric sepsis remains a major cause of maternal mortality. Early recognition and interventions are of great significance in reducing maternal mortality. We report a case of pregnant woman with inevitable abortion who developed septic shock and was successfully treated through multidisciplinary collaboration. The patient was a 27-year-old primipara. After in vitro fertilization-embryo transfer (IVF-ET), at the mid trimester of pregnancy, amniocentesis was performed to rule out possible fetal chromosomal abnormalities due to the fetus having a right-side aortic arch. Premature rupture of membranes occurred 16 days after the amniocentesis. During the induction of labor, the patient presented with high fever, persistent hypotension, elevated white blood cells and procalcitonin, along with elevated blood lactic acid and creatinine and thrombocytopenia. After multidisciplinary collaborative treatment including fluid resuscitation, upgraded antibiotic therapy, vasopressors, and bedside continuous renal replacement therapy, the patient improved and was discharged from the hospital. This case suggests that obstetric sepsis and septic shock should be vigilant after amniocentesis. It also emphasizes the importance of early recognition, timely intervention and multidisciplinary collaboration in the successful management of obstetric sepsis and septic shock.

Key words: Sepsis, Shock, septic, Amniocentesis, Continuous renal replacement therapy, Abortion