Characteristics and pathogenic analysis of patients with sepsis during pregnancy and postpartum period
Objective:To investigate the clinical features,the pathogenic microbiological characteristics and the risk fac-tors in the process of progression to septic shock of patients with sepsis during pregnancy and postpartum period.Methods:The clinical data of 58 patients with sepsis during pregnancy and postpartum period from June 2012 to June 2022 were selected and divided into group A(patients with shock)and group B(patients without shock)according to whether the patients with shock or not.The clinical features,the pathogenic characteristics,the treatment and the prognosis of the patients in the two groups were analyzed.Results:There were 48(82.8％)patients in group B and 10(17.2％)patients in group A.The rate of the sepsis diagnosed before delivery of the patients in group A was signifi-cantly higher than that of the patients in group B.The gestational weeks of the patients with postpartum sepsis in group A were significantly less than that of the patients in group B.The rats of in vitro fertilization and embryo transfer pregnancy,the delivery complications,the emergency cesarean section,the reproductive tract invasive operation,the respiratory system disorders,the coagulation system disorders,the central nervous system disorders and the cardiac dysfunction of the patients in group A were significantly higher than those of the patients in group B.The number of dysfunctional organs,the rates of multiple organ dysfunction syndrome,disseminated intravascular coagulation,mean arterial pressure(MAP)≤65mmHg and sequential organ failure,the lactic acid value,the exhaustion score,the rate of intensive care unit admission and the duration of stay in care unit,and the rates of vasoactive drugs and blood transfusion products used of the patients in group A were significantly higher than those of the patients in group B(all P＜0.05).Logistic regression analysis showed that the emergency cesarean section and MAP≤65mmHg of the pa-tients were the independent risk factors of their obstetric sepsis occurrence(all P＜0.05).Conclusion:The emergency cesarean section and MAP≤65mmHg of the patients are the independent risk factors of their obstetric occurrence.The patients with sepsis or with suspected sepsis should be enhanced the monitoring in clinic for early finding the high-risk factors.The sepsis of the patients should be identified and treated early,so as to improve the prognosis of the patients at the greatest extent.
万方数据
维普
