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Review paper

Obstetric shock and shock in obstetrics – steady obstetrical syndrome

By
Anis Cerovac Orcid logo ,
Anis Cerovac
Contact Anis Cerovac

Department of Gynaecology and Obstetrics, General Hospital Tešanj , Tešanj , Bosnia and Herzegovina

University of Tuzla, School of Medicine , Tuzla , Bosnia and Herzegovina

Dubravko Habek ,
Dubravko Habek

Clinical Hospital, „Sveti Duh" , University Department of Gynaecology and Obstetrics , Zagreb , Croatia

School of Medicine, Croatian Catholic University Zagreb , Zagreb , Croatia

Elmedina Cerovac ,
Elmedina Cerovac

School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

Department of Anaesthesiology, Reanimatology and Intensive Medicine, General Hospital Tešanj , Tesanj , Bosnia and Herzegovina

Jasna Čerkez Habek
Jasna Čerkez Habek

Clinical Hospital, „Sveti Duh" Zagreb, University Department of Gynaecology and Obstetrics , Zagreb , Croatia

School of Medicine, Croatian Catholic University Zagreb , Zagreb , Croatia

Abstract

Obstetric shock (OS) has been defined as a life-threatening cardiovascular collapse syndrome associated with pregnancy, childbirth and puerperium (obstetrics causes), and is the most significant cause of high maternal mortality (MM) throughout human history. Shock in obstetrics (SIO) refers to indirect causes of non-obstetrics causes in pregnancy, childbirth and puerperium (polytrauma, aesthetic incidents, cardiovascular or cerebrovascular incidents, other septic syndromes). The goals of OS treatment are: to quickly detect the location or cause of bleeding / injury / inflammation, prevent the progression of shock, prevent massive transfusions, preserve the uterus (and adnexa), and preserve fertility if possible. Surgical treatment of septic shock includes exploratory laparotomy (laparoscopy), ectomy or resection of the necrotized organ,
abdominal lavage with multiple drainages, continuous peritoneal drainage with lavation, extensive triple antibiosis per admission or per antibiogram and thromboprophylaxis. OS seems to remain a permanent miasma in practical clinical obstetrics, which we will not be able to influence, because we have obviously caused today's increase in MM from haemorrhagic OS by iatrogenic increase in the number of caesarean sections, especially elective ones.

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