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Occurrence of Septic Shock in a Patient Submitted to Emergency Cerclage following a Negative Amniocentesis: Report of a Case.
MedLine Citation:
PMID:  22889807     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Second trimester emergency cerclage is an option for pregnant women presenting bulging fetal membranes. Despite a significant prolongation of pregnancy might be achieved, serious fetal and maternal events have been reported. Exclusion of infections through preprocedure amniocentesis has been proposed. Methods: A 37-year-old woman, gravida 4 para 1, was admitted at 21 weeks of gestation to our University Hospital due to bulging fetal membranes. An amniocentesis was performed in order to exclude an actual amniotic infection. Our Microbiology Department found a negative amniotic culture for bacteria and Mycoplasma and a normal glucose and interleukin-6 level, so a cervical cerclage was performed. The patient was discharged home on oral erythromycin. Results: After 48 h, the patient complained of hyperpyrexia, shivers and reduced fetal movements. Ultrasound at admission showed absent cardiac activity and after cerclage removal a non-viable fetus was delivered vaginally. Piperacillin and tazobactam were started, but the clinical course of the patient deteriorated and she developed a cold septic shock and was submitted to hysterectomy and transferred to the ICU of our hospital. Conclusion: This report heralds that even after negative amniocentesis, a life-threatening infection may not be excluded in women candidate for emergency cerclage due to bulging fetal membranes.
Authors:
T Ghi; F Bellussi; A Curti; A Youssef; A Bianchi; L De Eccher; G Turchi; M P Rainaldi; P De Iaco; G Pilu; N Rizzo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-08
Journal Detail:
Title:  Fetal diagnosis and therapy     Volume:  -     ISSN:  1421-9964     ISO Abbreviation:  Fetal. Diagn. Ther.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9107463     Medline TA:  Fetal Diagn Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Department of Obstetrics and Gynecology, University Hospital, Bologna, Italy.
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