Factors Associated With Multiple Organ Dysfunction Syndrome in Patients With Obstetric Hemorrhage in Critical Care [31K]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 129 Suppl 1; no. 1; pp. 119S - 120S
• Main Authors: Eliana, Montoya, Carrizosa, Jorge, Nino, Reinaldo, Castro, Alejandro
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2017
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000514624.52117.6b

INTRODUCTION:Obstetric hemorrhage is one of the leading causes of death in obstetric patients in developing countries. Every year, 14 million cases of obstetric hemorrhage occur globally, 1% of them dies. Multiple organ dysfunction syndrome (MODS) occurs between 7% to 15% of patients and has a 90% mortality when three or more organs are affected. METHODS:The aim of this study was to determine the risk to develop MODS in patients with obstetric hemorrhage using laboratory results at critical care unit admission. A retrospective case-control study was conducted in four university hospitals in Bogota, Colombia, between 2008 and 2014. Logistic regression analysis was conducted. RESULTS:We collected information from 277 cases and 558 controls. Of them, 84.9% was pregnant and 15.1% in the puerperium. The mean age was 27.8 years old (SD 7.3) and mean gestational age was 32.1 weeks (SD 7.1). Hemorrhage was the second most frequent diagnosis (12.2%). Multivariate analysis of hemorrhage diagnosis identified factors associated with MODScreatinine levels equal or greater than 0.65 mg/dL (OR 1.8 95%CI 1.4-5.3; p < 0.003), platelets equal or less than 200.000 mm3 (OR 2.1 95%CI 1.4-3.2; p < 0.000), aspartate aminotransferases equal or greater than 80 (OR3.3 95%CI 1.7-6.6; p < 0.001), alanine aminotransferase equal or greater than 40 (OR 1.9 95%CI 1.1-3.3; p < 0.019) and total bilirubin equal or greater than 0.8 (OR 1.8 95%CI 1.1-3.0; p < 0.016). CONCLUSION:In patients with obstetric hemorrhage, platelet count, serum creatinine, and liver function test can be associated with MODS, even at values considered as normal.