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

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Abstract

Objective

The purpose of this study was to describe the clinical course, complications, and outcome of patients with septic abortion admitted to the intensive care unit (ICU).

Design, setting, and patients

In this retrospective study, the records of 63 patients with septic abortion admitted to the ICU of a university hospital in Argentina between 1985 and 1995 were reviewed.

Results

The mean age of the patients was 28.5 years, and 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 of 63) of the patients, disseminated intravascular coagulation (DIC) in 31% (15 of 49), and septic shock in 32% (20 of 63). Blood cultures were positive in 24% (15 of 62). Twelve patients died (19%). Eight of the deaths occurred during the first 48 h of the ICU admission. Compared with survivors, non-survivors had higher median number of organ failures (1.0 vs 4.0, p<0.0001), mean first ICU day SOFA scores (6.6 vs 10.0, p=0.0059), 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

Although it is an avoidable complication, septic abortion requiring admission to the ICU is associated with high morbidity and mortality.

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA

    Javier Daniel Finkielman & Bekele Afessa

  2. Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina

    Fabián Darío De Feo & Paula Graciela Heller

Authors
  1. Javier Daniel Finkielman
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  2. Fabián Darío De Feo
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  3. Paula Graciela Heller
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  4. Bekele Afessa
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Correspondence to Bekele Afessa.

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Finkielman, J.D., De Feo, F.D., Heller, P.G. et al. The clinical course of patients with septic abortion admitted to an intensive care unit. Intensive Care Med 30, 1097–1102 (2004). https://doi.org/10.1007/s00134-004-2207-7

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  • DOI: https://doi.org/10.1007/s00134-004-2207-7

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