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


METHODS
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.
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
JD
Finkielman
Fabián Darío
FD
De Feo
Paula Graciela
PG
Heller
Bekele
B
Afessa
D018806:APACHE; D000031:Abortion, Septic / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome