패혈성유산에 관한 임상적 고찰

Abstract

[한글]

[영문]Despite of modern medical and surgical methods of treatment, septic abortion and septic shock can be life-threatening and when encountered always represents a difficult management problem and the maternal mortality attributed to this complication remains high.

The purpose of this investigation is to document the high risk indiscriminate use of various artificial abortions, especially on the serious septic abortion and shock following artificial abortion, from clinical analysis and evaluation on 52 cases of septic abortion, who were admitted and treated at the Yonsei University Medical Center from 1964 to 1974, to prevent this disease and to make suggestions for therapy.

The followings were the result of this study.

1. Septic abortions occurred most frequently in the 21-30 age group.

2. The majority of the septic patients aborted in the 13th to 20th week of gestation and infected by using of bougination and laminaria.

3. The symptoms and signs of septic abortion appeared in 12-72 hours after the manipulation of induced abortion, with the findings of ta chycardia, high fever, shaking chills, hypotension, abdominal pain and olig uria.

4. Most frequent organism responsible for septic abortions are E.coli-aerobacter group bacteria and the presence of septicemia was proven by positive blood cultures in 27%, in which Staphylococcus was the most frequent bacteria.

5. In septic shock, the measurement of CVP and blood gas study were the most important for the evaluation of the patient and low CVP with metabolic acidosis believed to be a bad prognostic signs of septic shock.

6. Surgical management was better than medical management and the surgical management should be done as soon as possible in all cases unless this is contraindicated on some sound basis.

7. The mortality rate in septic abortion and septic shock group were 11.5% and 26.1%, respectively.

8. The complications of the septic abortion involved septic shock, septic pneumonitis, pulmonary edema, congestive heart failure, renal failure and disseminated intravascular coagulation.