Sepsis and Septic Shock in Pregnancy - Children's Memorial ...

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Drotrecogin Alfa (Xigris)• Decreases microvascular thrombosis• Decreases duration of hypotension• BUT– Increases risk of fatal bleeding (1.5-5%)– Very expensive• * FDA market withdrawal (10/25/2011)– PROWESS-SHOCK trial– Failure to show survival benefit
Septic Shock in Pregnancy• Case series of 18 patients– 13 survivors– 5 non-survivors• Causes of shock– Pyelonephritis (n = 6)– Chorioamnionitis (n = 3)– Postpartum endometritis (n = 2)– Toxic shock (n = 2)Mabie W, Barton J, Sibai B. Obstet Gynecol 1997
Page 1 and 2:
Sepsis and Septic Shockin Pregnancy
Page 3 and 4:
Cases / 100,000Deaths/YearCompariso
Page 5 and 6:
Maternal mortality, 1842“It is no
Page 7 and 8:
The Intervention:Hand scrub with ch
Page 9 and 10: Definitions• Sepsis- SIRS due to
Page 11 and 12: Case History• 31 wks, sore throat
Page 13 and 14: Group A StreptococcusThe Etiology,
Page 17 and 18: MicroabscessFascia
Page 19 and 20: Early Goal Directed Therapy• Earl
Page 21 and 22: Mortality (%)The Importance of Earl
Page 23 and 24: Algorithm for Septic Shock in Pregn
Page 25 and 26: Antimicrobial Therapy• Infection
Page 27 and 28: Post-op C/SMultilocularabscessDispl
Page 29 and 30: Postpartumnecrotizingfasciitis
Page 31 and 32: Empiric Antimicrobial Therapy• Ge
Page 33 and 34: Vasoactive Therapy• Indication- H
Page 35 and 36: Corticosteroids• Treat patients w
Page 37 and 38: Presentation: Temp 103.5, severe fl
Page 39 and 40: Maintenance PhaseAnticipation of co
Page 41 and 42: H1N1 influenza-associated ARDS: Bil
Page 43 and 44: Indications for surgical interventi
Page 46 and 47: Obesity Trends*Among U.S. AdultsDon
Page 48 and 49: Outcome
Page 50 and 51: References• Mabie WC, Barton JR,
Page 52 and 53: References• Walsh C, Scaife C, Ho
Page 54 and 55: References• Kitter ND, McMullen K
Page 56 and 57: Historical Guidelines for Sepsis Th
Page 58 and 59: Probability of SurvivalFluid Resusc
Page 62 and 63: VentricularFunctionGroup INormalGro
Page 64 and 65: Varicella-Zosterin Pregnancy
Page 66: BACKGROUNDGlobal• Puerperal sepsi
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Sepsis and Septic Shock in Pregnancy - Children's Memorial ...

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