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Septic shock in obstetrics and gynecology

An evaluation of metaraminol therapy
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      Abstract

      • 1.
        1. Thirty-five women in septic shock treated with metaraminol were studied. Their ages ranged from 17 to 65 years with the median age being 37 years. The most common cause of shock was septic abortion.
      • 2.
        2. Twenty-three patients survived, but whereas 21 of 24 patients in moderate shock survived, only 3 of 11 patients in severe shock remained alive. This emphasizes the great need for early diagnosis as well as adequate treatment.
      • 3.
        3. Metaraminol appears to be a useful agent in the management of septic shock. It has a relatively rapid onset and protracted action with minimal side effects. Patients who failed to respond to metaraminol were not improved when given other more potent vasopressor agents such as l-norepinephrine.
      • 4.
        4. Corticosteroids were combined with vasopressor therapy in 18 patients and 16 of these responded satisfactorily.
      • 5.
        5. Three patients maintained on metaraminol for over 48 hours, including one for 96 hours, recovered. Although vasopressors should be discontinued as soon as possible, these survivals suggest that perhaps the dangers of prolonged vasopressor therapy have been exaggerated.
      • 6.
        6. In the patient with a septic incomplete abortion, the use of a suitable vasopressor is particularly useful to allow time for adequate evaluation of the patient, the institution of antibiotic therapy, and prompt evacuation of the uterus.
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