Pregnancy outcome of patients with septic shock complicating pregnancy: a retrospective study

Background: To detect the maternal and neonatal outcomes of late pregnant patients complicated with sepsis shock. Methods: The medical records of all late pregnant patients (>=28 weeks) complicated with septic shock during January 2011 and November 2018 in Peking Union Medical College Hospital were retrospectively reviewed. Pertinent literature was identified by searching PubMed and EMBASE. Results: A total 9 patients with an average age of 26.11±6.9 years were included in this study. And the mean gestational age at diagnosis of septic shock was 33 weeks plus 1 day. 87.5% of patients accepted emergency delivery ,in which cesarean section was the main delivery mode. 7 patients underwent emergency delivery (including 3 cases of fetal death) and 3 cases of live births (including 1 case of mild neonatal asphyxia). The total maternal mortality rate was 33.3 percent,and neonatal death rate was 55.6%. Only 1 patient continued pregnancy after disease recovery. 15 published case reports were reviewed. The reported maternal and perinatal death rates were 20% and 46.7% respectively. 2 patients could continue pregnancy after treatment. Group A streptococcus was considered as the main pathogenic bacteria. Conclusions: Late pregnancy complicated with septic shock was associated with high maternal and fetal mortality. Emergency delivery was advised in most of patients. And cesarean section was the main mode of delivery.