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Gynaecology & Obstetrics Miscellaneous (Gynae) 51531405

Common cause of "Sepsis syndrome" in obstetrics includes

A
Antepartum pyelonephritis
B
Puerperal infection
C
Chorioamnionitis
D
All of the above
High-Yield Explanation
Ans. d (All of the above)SEPSIS SYNDROME# The sepsis syndrome is induced by a systemic inflammatory response to bacteria or their by-products such as endotoxins or exotoxins.# Infections that most commonly cause the sepsis syndrome in obstetrics are:- Antepartum pyelonephritis,- Chorioamnionitis and puerperal sepsis,- Septic abortion, and- Necrotizing fasciitis.# Etiopathogenesis- usually polymicrobial- most commonly Escherichia coli.- Other pathogens are aerobic and anaerobic streptococci, Bacteroides species, and Clostridium species. Some group A -hemolytic streptococci and Staphylococcus aureus produce virulent exotoxins that can rapidly cause all features of the sepsis syndrome. Some virulent streptococci produce proteases that degrade IL-8. In pyelonephritis, E coli and Klebsiella species commonly cause bacteremia and sepsis syndrome.- Endotoxin is a lipopolysaccharide released on lysis of the cell wall of gram-negative bacteria.- A number of potent bacterial exotoxins can also cause severe sepsis syndrome. Examples include exotoxins from Clostridium perfringens, toxic shock syndrome toxin from S aureus, and toxic shock-like exotoxin from group A -hemolytic streptococci.- These exotoxins cause rapid and extensive tissue necrosis and gangrene, especially of the postpartum uterus, and may cause profound cardiovascular collapse with maternal death.

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