July 13th, 2020

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Treatment of Septic Shock in the Second Trimester with Dilation and Evacuation: A Report of 3 Cases
Authors:  Mirella Mourad, M.D., Annie Fu, M.D., Paula M. Castaño, M.D., Mary D’Alton, M.D., and Anne Davis, M.D.
BACKGROUND: Sepsis is a leading cause of pregnancy-related morbidity and mortality in the United States. The management of intrauterine infections in pregnancy leading to septic shock is not well-defined in the literature.
CASES: We report 3 cases of women in the second trimester of pregnancy with septic shock secondary to an intrauterine infection. The patients, ranging in gestational age from 19–25 weeks, were successfully treated with a combination of intravenous antibiotics, urgent dilation and evacuation, and medical support in the intensive care unit.

CONCLUSION: Dilation and evacuation represents a cornerstone of treatment of intrauterine infection with septic shock in the second trimester. Expeditious access to dilation and evacuation in hospital settings can prevent maternal morbidity and mortality.
Keywords:  critical care; dilation and evacuation; maternal mortality; obstetric delivery; obstetric labor; post-partum; pregnancy; pregnancy complications, infectious; sepsis
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