{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:03:00Z","timestamp":1723075380465},"reference-count":0,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":2191,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"},{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":2191,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Infectious Diseases in Obstetrics and Gynecology"],"published-print":{"date-parts":[[1994,1]]},"abstract":"<jats:p>Septic shock is a life\u2010threatening clinical syndrome that, despite its rare occurrence in obstetrics,\nremains a leading cause of maternal mortality. Its pathophysiology is explained by a profound\nsystemic response to a complex variety of host cellular and humoral mediators elaborated after\nexposure to microbial toxins. Early recognition, prompt diagnostic workup, and immediate initiation\nof therapy improve outcomes. Therefore, recent publications have popularized the concept of the\n\u201csepsis syndrome,\u201d a preshock list of clinical criteria associated with progressive sepsis. Needed\ndiagnostic studies should never be withheld because of \u201cpregnancy concerns.\u201d With critically ill\npatients, the risk\u2010to\u2010benefit ratio supports the use of these diagnostic studies in almost all circumstances.\nStandard therapy is directed principally at restoring tissue perfusion by intravascular\nvolume expansion and in some instances vasoactive pharmacological intervention. Simultaneously,\nidentification of the source of infection and commencement of appropriate empiric antibiotic treatment\nare critical. In some cases, surgical abscess drainage or debridement of infected necrotic tissue\nwill need to be considered. Novel approaches to treatment that attempt to reduce the systemic\nresponse to microbial toxins are promising and under active investigation. Pregnancy\u2010specific considerations\ninclude the following: 1) initial signs or symptoms of septic shock may be masked by\nnormal physiologic alterations of pregnancy; 2) a mixed polymicrobial group of organisms, consistent\nwith lower genital tract flora, should be anticipated; and 3) initial therapy should be directed\nat maternal concerns since adverse fetal effects are most likely the result of maternal decompensation.<\/jats:p>","DOI":"10.1155\/s1064744994000645","type":"journal-article","created":{"date-parts":[[2007,3,7]],"date-time":"2007-03-07T13:01:22Z","timestamp":1173272482000},"page":"190-201","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Septic Shock and Sepsis Syndrome in Obstetric Patients"],"prefix":"10.1155","volume":"2","author":[{"given":"Peter G.","family":"Pryde","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Gonik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1994,6,3]]},"container-title":["Infectious Diseases in Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/idog\/1994\/923847.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/S1064744994000645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T20:00:51Z","timestamp":1723060851000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/S1064744994000645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,1]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1994,1]]}},"alternative-id":["10.1155\/S1064744994000645"],"URL":"https:\/\/doi.org\/10.1155\/s1064744994000645","archive":["Portico"],"relation":{},"ISSN":["1064-7449"],"issn-type":[{"type":"print","value":"1064-7449"}],"subject":[],"published":{"date-parts":[[1994,1]]},"assertion":[{"value":"1994-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1994-06-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-01-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}