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KMID : 0438219730100010469
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Korea University Medical Journal
1973 Volume.10 No. 1 p.469 ~ p.476
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The Clinical and Statistical Study on the Obstetric Shock
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Abstract
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The olstetric shock which still maintains the highest maternal mortality is the important and difficult problem faced by obstetricians.
The results of the statistical study of 104 cases of the obstetric shock from January 1st. 1967 to December 31st. 1971 were obtained as following;
1. The incidence of the obstetric shock among total obstetric inpatients of 5122 was 104 and 2.0 per cent.
2. The incidence of the obstetric sepsis among total hospitalized sepsis of 130 was 57 and 44.6 per cent. The incidence of the septic shock in obstetric sepsis of 58 was 25 and 44.1 per cent.
3. Among 104 cases of the obstetric shock patients, most of them were in the age group of 40-49 years (11.8%) The incidence of the obstetric shock increased as the parity and the age of the mother get greater.
4. The etiological factors in obstetric shock of 104 cases were divided into hemorrhagic (75.9%) and non-hemorrhagic (24.1%) groups. The ectopic pregnancy had the most of 44.2 per cent among them and other factors were sepsis following dilatation and curettage for termination of pregnancy(11.6%), retained placenta (8.9%). uterine rupture (7.9%) and other abortions (7.7%), respectively.
5. Among 89 cured cases. 70 per cent in hemorrhagic shock recovered within 1 hour, and in septic shock, 42.1 per cent within 24 hours, and 31.6 per cent more than 47 hours.
6. Majority of preceding causes were septic abortions (84%) in 25 cases of septic shock, and most of them (72%) showed symptoms and signs of shock within 3 days after obstetric intervention.
7. The results of the blood chemistry in 18 cases in septic shock showed abnormally increased values as follows: N. P. N. (72.2%), B. U. N. (61.1%), Creatinine (61.1%), Uric acid (44.4%). 66.1 per cent showed the evidence of acidosis. The alkaline phosphatase (33.3%) which was related to liver function, were abnormally increased.
8. In blood culture of 25 cases of septic shock, 78.9 per cent showed the growth of Gram negative bacilli and 21.1 per cent of Gram positive cocci. The majority of organisms were E. coli (63.2%).
9. The maternal mortality of obstetric shock was 14.4 per cent. In detail, the maternal mortality of hemorrhagic and septic shock were 11.4 per cent and 24 per cent, respectively.
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