Abstract

VIRUEZ-SOTO, José Antonio et al. MULTIPLE ORGAN DYSFUNCTION IN OBSTETRICS CRITICAL CARE. Rev. Méd. La Paz [online]. 2017, vol.23, n.1, pp.46-51. ISSN 1726-8958.

The death of an obstetric patient with critical illness is frequently preceded by multiple organ dysfunction, the early recognition and management of this situation as well as the availability and accessibility to health centers with the capacity to resolve such situations is essential to reduce maternal mortalityin a region. The objective is to report the case of a patient with progression to multiple organ dysfunction during the mediate postoperative period, fortunately, with favorable evolution. Patient of 26 years of age, resident of the El Alto, without relevant personal pathological antecedents with clinical presentation of 4 days of evolution after cesarean with progressive clinical impairment with asthenia, adynamia, progressive jaundice, oliguria, abdominal ultrasound with puncture is performed, evidencing massive hemoperitoneum from a bleeding epigastric artery in the transoperative. The patient is received in an intensive care unit with an APACHE II score at 24 hours of 26 points, with a score predicted mortality probability of 38% and SOFA score of 16 points. The subsequent evolution was favorable. The case reveals several important data, such as the transfer of a patient with non-specific clinical presentation, however the ultrasound allowed the identification of the primary cause of the clinical presentation. The report of this case exposes the rapid recovery of the obstetrical patients with critical illness when the causal agent is identified. The obstetric event may present different complications that expose the patient to critical illness with a life-threatening condition; however, timely management can avoid a maternal death.

Keywords : Obstetrics critical care; critical care and intensive medicine; maternal mortality.

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