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产妇脓毒症。

Maternal sepsis.

机构信息

IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Via della Pineta Sacchetti 217, 00168 Rome, Italy.

UZ Leuven Department of Anesthesiology, KULeuven, Department of Cardiovascular Sciences, Herestraat 49, 3000 Leuven, Belgium.

出版信息

Best Pract Res Clin Anaesthesiol. 2022 May;36(1):165-177. doi: 10.1016/j.bpa.2022.03.003. Epub 2022 Mar 30.

Abstract

Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection that can arise during pregnancy, childbirth, postabortion, or in the postpartum period. Validated diagnostic criteria of maternal sepsis and septic shock may reduce the impact of this condition on maternal health worldwide, but the lack of consensus on adequate tools due to the overlap between physiological adaptations that occur during pregnancy and signs and symptoms of infection and sepsis can delay both diagnosis and treatment. In the absence of evidence-based guidelines for obstetric populations, the WHO recommends the use of the "Surviving Sepsis Campaign" sepsis protocols for maternal care adapted to the local obstetric population. Interventions within the first hour from diagnosis have been proposed in 2021 to emphasize the state of emergency of a maternal sepsis. This review will highlight the utility of standardized diagnostic criteria, the implemented approaches for the prevention and treatment of maternal infections, and the strategies for early management of critically ill parturients.

摘要

产妇脓毒症是一种危及生命的病症,定义为感染导致的器官功能障碍,可发生在妊娠、分娩、流产后或产后期间。经过验证的产妇脓毒症和脓毒性休克的诊断标准可以减少这种病症对全球产妇健康的影响,但由于妊娠期间发生的生理适应与感染和脓毒症的体征和症状之间存在重叠,缺乏足够工具的共识可能会延迟诊断和治疗。在没有针对产科人群的循证指南的情况下,世界卫生组织建议使用“拯救脓毒症运动”脓毒症方案,对适应当地产科人群的产妇进行护理。2021 年提出了在诊断后第一个小时内进行干预的建议,以强调产妇脓毒症的紧急状态。这篇综述将重点介绍标准化诊断标准的实用性、预防和治疗产妇感染的方法以及危重症产妇的早期管理策略。

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