The clinical course of patients with septic abortion admitted to an intensive care unit

FINKIELMAN JAVIER D; DE FEO FABIÁN D; HELLER PAULA G; AFESSA BEKELE

INTENSIVE CARE MEDICINE

SpringerLink

Año: 2004 vol. 30 p. 1097 - 1102

0342-4642

Background Septic abortion is a serious and common threat to the health of women in developing countries, where it is illegal or inaccessible. Data addressing the clinical course and outcome of patients admitted to the intensive care unit (ICU) for septic abortion are scarce. Methods The records of 63 patients with septic abortion admitted to the ICU of a university hospital in Argentina between 1985 and 1995 were retrospectively reviewed. Results The mean age of the patients was 28.5 years, 33% had had previous abortions. The mean gestational age was 10.5 weeks. The first ICU day Acute Physiology and Chronic Health Evaluation (APACHE) II mean score was 13.9. Acute renal failure developed in 73% (46/63) of the patients, disseminated intravascular coagulation (DIC) in 33% (16/49), and septic shock in 32% (20/63). Blood cultures were positive in 24% (15/62). Twelve patients died (19%, 95% CI: 9.4 to 28.7). Eight of the deaths occurred during the first 48 hours of the ICU admission. Compared to survivors, non-survivors had higher median number of organ failures (1.0 vs. 4.0, P < 0.0001)) and mean APACHE II scores (12.7 vs. 20.2, P= 0.0003), and were more likely to have septic shock (18 vs. 92%, P < 0.0001), and receive dopamine (37 vs. 83 %, P= 0.0040), mechanical ventilation (8 vs. 83%, P< 0.0001), and pulmonary artery catheter (8 vs. 41 %, P= 0.0026). Conclusions Septic abortion requiring admission to the ICU is associated with high morbidity and mortality.