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      Aborto séptico en el Hospital "Dr. Adolfo Prince Lara" 1977-2006

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          Abstract

          Objetivo: Determinar la incidencia del aborto séptico, características maternas y factores relacionados. Métodos: Estudio retrospectivo, descriptivo y analítico de 9 529 abortos sucedidos durante 1997-2006, de los cuales 168 fueron sépticos. Hubo un aborto séptico por cada 57 abortos. Ambiente: Hospital "Dr. Adolfo Prince Lara", Puerto Cabello. Resultados: El aborto séptico tuvo una incidencia 1,76 % con rangos de 0,67 % (1997) y 2,87 % (2003), hay tendencia a cifras mayores en los últimos 5 años. Pacientes residentes urbanas eran 89 (52,98 %), solteras 107 (63,70 %), de 24 años y menos 94 (55,96 %), con gestaciones entre II-V 118 (70,24 %), edad de embarazo menor de 10 semanas 102 (60,72 %), 8 pacientes (4,76 %) tenían antecedente de ingesta de misoprostol. El diagnóstico fue fundamentalmente por clínica, ecografía y laboratorio en 106 casos (63,1 %); grado séptico I (91,07 %), tratadas con antibióticos y curetaje la mayoría 159 (94,64 %), permanecieron hospitalizadas de dos o tres días el 58,93 %, la mayor morbilidad fue anemia en un 71,16 %. La mortalidad materna fue de 2,38 % o una cada 42 abortos sépticos. Conclusión: El aborto séptico mostró una incidencia baja con una alta morbimortalidad, se asoció a factores socioconómicos. En consecuencia, deben incrementarse los programas preventivos de salud sexual y reproductiva y apoyo familiar

          Translated abstract

          Objective: To determine the incidence of septic abortion, maternal characteristics and related factors. Methods: Retrospective, descriptive and analytic study of 9 529 abortions happened during 1997-2006, from which 168 were septic. There was one septic abortion each 57 abortions. Setting: Hospital Dr. Adolfo Prince Lara, Puerto Cabello, Estado Carabobo. Results: The septic abortion had an incidence of 1.76 % with ranks of 0.67 % (1997) and 2.87 % (2003), with tendency to higher numbers in 5 last years. Were urban residents 89 patients (52.98 %), unmarried 107 (63.70 %), of 24 years and less 94 (55.96 %), with gestations between II-V 118 (70.24 %), age of pregnancy lower than 10 weeks 102 (60.72 %), and history of misoprostol ingestion 8 patients (4.76 %). Basicly the diagnostic was by clinical, ultrasound and laboratory in 106 cases (63.1 %), septic abortion degree I 153 (91.07 %), treatment with antibiotics and curettage 159 (94.64 %), remaining hospitalized from 2 or 3 days 99 (58.93 %), the greater morbidity was anemia 133 (71.16 %). Maternal mortality 2.38 % (4/168) or each for 42 septic abortions. Conclusion: The septic abortion showed a low incidence with an important morbid-mortality, is associated to social-economic factors. Consequently, the preventive programs of sexual and reproductive health and familiar support must be increased

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          Septic shock in pregnancy.

          To evaluate the etiology, management, and maternal and perinatal outcome in patients with septic shock during pregnancy. In 18 patients with septic shock during pregnancy, the criteria for the diagnosis were sepsis-induced hypotension unresponsive to adequate fluid resuscitation and requirement for vasopressors. Causes of shock were pyelonephritis (n = 6), chorioamnionitis (n = 3), postpartum endometritis (n = 2), toxic shock (n = 2), and one each of septic abortion, ruptured appendix, ruptured ovarian abscess, necrotizing fasciitis, and bacterial endocarditis. Five women (28%) died. Comparing medians of the initial laboratory data for the 13 survivors with those of the five nonsurvivors revealed significant differences for hematocrit (26 compared with 35%; Z = -2.267, P = .023), aspartate aminotransferase (30 compared with 287 U/L; Z = -2.068, P = .042), total bilirubin (1.6 compared with 5.8 mg/dL; Z = 2.046, P = .045), arterial carbon dioxide pressure (30 compared with 19 mmHg; Z = -2.384, P = .013), and arterial oxygen pressure (62 compared with 104 mmHg; Z = -2.004, P = .048). Comparing medians of the hemodynamic data showed differences in blood pressure (88 compared with 70 mmHg; Z = -2.439, P = .013), stroke volume (74 compared with 52 mL; Z = -2.041, P = .038), and left ventricular stroke work index (42 compared with 12 g.m.m2; Z = -1.929, P = .052). Sixty-four percent of survivors and 80% of nonsurvivors had depressed left ventricular function (Fisher exact test, P > .99). Locating the source of infection was difficult and delayed in eight patients. In women with septic shock, progression to death can be dramatically rapid. Because vascular permeability is increased, it may be appropriate to administer vasopressors early during resuscitation. An initial low cardiac output is a poor prognostic sign.
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            Sharing responsability: women, society and abortion worldwide

            (1999)
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              Mortalidad materna en el Servicio de Obstetricia del Hospital Adolfo Prince Lara

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                September 2007
                : 67
                : 3
                : 174-178
                Affiliations
                [1 ] Hospital Dr. Adolfo Prince Lara
                Article
                S0048-77322007000300005
                0d1c5049-d61e-4f4d-bad5-83710f6467cc

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Abortion,Septic,Aborto,Sepsis
                Obstetrics & Gynecology
                Abortion, Septic, Aborto, Sepsis

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