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Revista Colombiana de Obstetricia y Ginecología

Print version ISSN 0034-7434

Abstract

VELASQUEZ-PENAGOS, Jesús Arnulfo et al. Population study of maternal mortality due to sepsis in Antioquia, Colombia, between 2004 and 2014: an overview of the challenge of timely identification and treatment. Rev Colomb Obstet Ginecol [online]. 2017, vol.68, n.3, pp.228-238. ISSN 0034-7434.  http://dx.doi.org/10.18597/rcog.1043.

Objective:

To describe the characteristics of women who died as a result of sepsis and to identify the care-associated factors contributing to those deaths in the Department of Antioquia, Colombia.

Materials and methods:

Case series study of maternal deaths caused by infection between the years 2004 and 2014. Maternal deaths were analysed based on the recommendations of the "Surviving Sepsis Campaign" and on clinical practice guidelines for specific infections. Judgements were made by consensus. The variables evaluated were timeliness of the diagnosis of sepsis, antibiotic treatment, septic shock, culture sampling, pregnancy termination, performance of surgery for controlling the source of the infection, admission to the intensive care unit, referral to a higher complexity level, and overall quality of management. Descriptive analysis.

Results:

Out of 476 maternal deaths in 11 years, 47 (9.87%) were non-obstetrical cases of sepsis and 11 (5.2%) were obstetrical. Pneumonia was the leading cause of death. All the cases were associated with at least one consideration of poor care quality. The main factors influencing the outcome were delays in symptom identification and antibiotic initiation; inadequate treatment of septic shock; care of women at levels with low resolution capacity; and failure to modify therapeutic measures, even in the face of patient decline.

Conclusion:

Maternal deaths from sepsis were mainly associated with non-obstetric causes. There are critical factors that can be modified, such as delay identifying the syndrome and timely initiation of adequate antibiotic therapy.

Keywords : Maternal mortality; sepsis; infection.

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