Septicaemia in Obstetrics
Toxic shock syndrome
- > 38.50, initially mild erythema (especially palms),
later multiorgan failure
- Staph toxin (TSST-1) ("TSS like syndrome" very similar but = group A strep)
- Postural hypotension
- Involve Microbiology and ITU Departments early in all suspected
cases
- Send cultures, U&E, LFT, Coag, CK
- Cultures may be negative - perform gram stain
- Beware early signs organ dysfunction +/- ARDS
- May need massive fluid resuscitation +/- ITU
- Remove appropriate material
- Flucloxacillin
Seen after
- After caesarean section, termination of pregnancy.
- 6% of maternal mortality.
- E. Coli, ß-haemolytic strep, bacteroides, clostridia.
Symptoms/Signs
- Confused, restless, coma.
- Warm sweaty extremities becoming cold.
- Peripheral or central cyanosis.
- Tachypnoea, tachycardia, hypotension.
- Jaundice, DIC
Treatment
- O2, intubation/ventilation.
- CVP, Swan-fluid replacement, FFP.
- Antibiotics - after cultures.
- Augmentin, Metronidazole, Gentamicin.
