Abstract
Abstract. Introduction. Sepsis is one of the most serious problems of modern obstetrics, accounting for 11% of the overall structure of maternal mortality. One of the main initial causes of sepsis is endotoxin having diverse biological effects. Moreover, during sepsis development, endotoxin directly or indirectly leads to irreversible and often life-incompatible damage to organs. Columns for direct hemoperfusion with polymyxin B are used for extracorporeal endotoxin removal. Aim: Reviewing the literature on using columns with polymyxin B in sepsis treatment and describing our own clinical observation of maternal sepsis. Materials and Methods. Review of publications in electronic resources, such as PubMed, eLibrary, EMBASE, and Google Scholar. This article presents a clinical case of successful sepsis treatment during late infected miscarriage in a young patient. Results and Discussion. Currently published systematic reviews and meta- analyses prove the reduction of mortality in patients with sepsis/septic shock. A 39-year-old patient was admitted with signs of chorioamnionitis and incipient miscarriage at 20-21 weeks of pregnancy. After the delivery of a dead fetus, the picture of sepsis and septic shock developed. Removal of the uterus as the primary source of infection did not improve the woman’s condition. Positive changes were only observed after having applied the polymyxin sorption of endotoxin. This new advanced technology in medicine, thanks to the timely use, correct dose, and duration of hemoperfusion with polymyxin B, made it possible to remove bacterial endotoxins safely and effectively from the blood, which led to the successful sepsis therapy. Conclusions. Thanks to the coordinated actions of a multidisciplinary team of highly qualified specialists and the timely administration of adequate therapy, it was possible to save the patient’s life, thus preventing her from maternal mortality.
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