Agarwal Mukta, Bhushan Divendu, Singh Shruti, Singh Shruti
Obstetrics and Gynaecology, AIIMS, Room No. 257, OPD Block (2-C), Patna, 801507 India.
General Medicine, AIIMS, Room No. 149, OPD Block (1-C), Patna, 801507 India.
J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):159-165. doi: 10.1007/s13224-021-01611-w. Epub 2022 Feb 11.
Sepsis is the dysregulated response of the body to the infection. Obstetric sepsis carries significantly greater morbidity and mortality as the condition is also augmented by the physiological adaptation of body during pregnancy. We conducted this study to determine the various epidemiological and clinical determinants of severity of sepsis which can help in prediction of survival in case of obstetric sepsis.
This retrospective study was conducted in a tertiary care center and all cases admitted with the diagnosis of obstetric sepsis as per the defined criteria between January 1, 2016 and December 31, 2020 were included in the study. Patients were evaluated for their clinical presentation, SOFA score, biochemical and microbiological parameters and the treatment given during their course of stay. Variables were compared among survivor and non-survivor group using appropriate statistical tests. Parameters which have significant association were further taken for binary logistic regression analysis.
A total 46 patients of obstetric sepsis were admitted under defined criteria. Twelve out of 46 patients did not survive (26.09%). On statistical analysis, mean SOFA score ( = 0.005) as well as patients with SOFA score > 6 ( = 0.029), presence of multi organ failure (0.04) and septic shock ( = 0.012) were found to be significantly associated with mortality.
The study suggests that these determinants of survival should always be evaluated while catering to a patient of obstetric sepsis in order to guide the treatment, prognostication and improving outcome of the patients.
脓毒症是机体对感染的失调反应。产科脓毒症的发病率和死亡率显著更高，因为孕期身体的生理适应也会加重这种情况。我们开展这项研究以确定脓毒症严重程度的各种流行病学和临床决定因素，这有助于预测产科脓毒症患者的生存情况。
这项回顾性研究在一家三级医疗中心进行，纳入了2016年1月1日至2020年12月31日期间根据既定标准诊断为产科脓毒症而入院的所有病例。对患者的临床表现、序贯器官衰竭评估（SOFA）评分、生化和微生物学参数以及住院期间接受的治疗进行了评估。使用适当的统计检验对幸存者和非幸存者组的变量进行比较。对具有显著关联的参数进一步进行二元逻辑回归分析。
共有46例符合既定标准的产科脓毒症患者入院。46例患者中有12例未存活（26.09%）。经统计分析，发现平均SOFA评分（P = 0.005）以及SOFA评分>6的患者（P = 0.029）、多器官功能衰竭（P = 0.04）和感染性休克（P = 0.012）与死亡率显著相关。
该研究表明，在诊治产科脓毒症患者时，应始终评估这些生存决定因素，以指导治疗、进行预后判断并改善患者的结局。
