Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Urology
Published in: BMC Urology 1/2023

Open Access 01-12-2023 | ECMO | Case report

Analysis of uroseptic shock after ureteroscopy for ureteral calculi during pregnancy: a case report

Authors: Wen Tang, Zhifei Xie, Mingwen Liu, ZeJu Zhao, Tao Wu

Published in: BMC Urology | Issue 1/2023

Login to get access

Abstract

Background

Uroseptic shock secondary to ureteral calculi during pregnancy is rare. It is characterized by rapid onset, rapid progression, aggressive disease, limited treatment, poor prognosis, and a mortality rate higher than 20% with improper or delayed management. A clear diagnosis is made based on typical clinical symptoms and abdominal ultrasound, often requiring combined multidisciplinary treatment and the simultaneous release of the obstruction. The high mortality rate is mainly related to inappropriate early treatment of stones and infections or failure to intervene in a timely manner.

Case presentation

A 21-year-old first-time pregnant patient with uroseptic shock was admitted to our intensive care unit. The patient was successfully treated at our hospital with multidisciplinary cooperation, high-dose vasoactive drugs, IABP, CRRT, VA-ECMO, and termination of pregnancy.

Conclusions

Timely relief of obstructions, termination of pregnancy, and the provision of IABP, CRRT, and VA-ECMO when necessary in critically ill patients with uroseptic shock during pregnancy can improve the success rate of resuscitation.
Literature
1.
Bonkat G, Cai T, Veeratterapillay R, et al. Management of urosepsis in 2018. Eur Urol Focus. 2019;5(1):5–9.CrossRefPubMed
2.
Filetici N, Van de Velde M, Roofthooft E, Devroe S. Maternal sepsis. Best Pract Res Clin Anaesthesiol. 2022;36(1):165–77.CrossRefPubMed
3.
Bozkurt Y, Soylemez H, Atar M, et al. Effectiveness and safety of ureteroscopy in pregnant women: a comparative study. Urolithiasis. 2013;41(1):37–42.CrossRefPubMed
4.
Bonet M, Nogueira Pileggi V, Rijken MJ, et al. Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation. Reprod Health. 2017;14(1):67.CrossRefPubMedPubMedCentral
5.
Shields A, de Assis V, Halscott T. Top 10 pearls for the recognition, evaluation, and management of maternal sepsis. Obstet Gynecol. 2021;138(2):289–304.CrossRefPubMedPubMedCentral
6.
Wagenlehner FM, Lichtenstern C, Rolfes C, et al. Diagnosis and management for urosepsis. Int J Urol. 2013;20(10):963–70.PubMed
7.
Knowles SJ, O’Sullivan NP, Meenan AM, Hanniffy R, Robson M. Maternal sepsis incidence, aetiology and outcome for mother and fetus: a prospective study. BJOG. 2015;122(5):663–71.CrossRefPubMed
8.
Benetis R, Nadisauskiene R, Sirvinskas E, et al. Successfully treated severe obstetric sepsis and acute respiratory distress syndrome with extracorporeal membrane oxygenation. Perfusion. 2016;31(4):343–6.CrossRefPubMed
9.
Dai JC, Nicholson TM, Chang HC, et al. Nephrolithiasis in pregnancy: treating for two. Urology. 2021;151:44–53.CrossRefPubMed
10.
11.
Fiadjoe P, Kannan K, Rane A. Maternal urological problems in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2010;152(1):13–7.CrossRefPubMed
12.
White J, Ory J, Lantz Powers AG, Ordon M, Kroft J, Cox A. Urological issues in pregnancy: a review for urologists. Can Urol Assoc J. 2020;14(10):352–7.CrossRefPubMedPubMedCentral
13.
Lee MS, Fenstermaker MA, Naoum EE, et al. Management of nephrolithiasis in pregnancy: multi-disciplinary guidelines from an academic medical center. Front Surg. 2021;8:796876.CrossRefPubMedPubMedCentral
14.
American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Committee opinion no. 656 summary: guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol. 2016;127(2):418.
15.
Giusti G, Proietti S, Peschechera R, et al. Sky is no limit for ureteroscopy: extending the indications and special circumstances. World J Urol. 2015;33(2):257–73.CrossRefPubMed
16.
17.
Evans HJ, Wollin TA. The management of urinary calculi in pregnancy. Curr Opin Urol. 2001;11(4):379–84.CrossRefPubMed
18.
Cormier CM, Canzoneri BJ, Lewis DF, Briery C, Knoepp L, Mailhes JB. Urolithiasis in pregnancy: current diagnosis, treatment, and pregnancy complications. Obstet Gynecol Surv. 2006;61(11):733–41.CrossRefPubMed
19.
Laing KA, Lam TB, McClinton S, Cohen NP, Traxer O, Somani BK. Outcomes of ureteroscopy for stone disease in pregnancy: results from a systematic review of the literature. Urol Int. 2012;89(4):380–6.CrossRefPubMed
20.
Song Y, Fei X, Song Y. Diagnosis and operative intervention for problematic ureteral calculi during pregnancy. Int J Gynaecol Obstet. 2013;121(2):115–8.CrossRefPubMed
21.
Semins MJ, Matlaga BR. Management of stone disease in pregnancy. Curr Opin Urol. 2010;20(2):174–7.CrossRefPubMed
22.
Butticè S, Laganà AS, Vitale SG, et al. Ureteroscopy in pregnant women with complicated colic pain: is there any risk of premature labor. Arch Ital Urol Androl. 2017;89(4):287–92.CrossRefPubMed
23.
24.
Srirangam SJ, Hickerton B, Van Cleynenbreugel B. Management of urinary calculi in pregnancy: a review. J Endourol. 2008;22(5):867–75.CrossRefPubMed
25.
Malhotra SK, Khaitan A, Goswami AK, Gill KD, Dutta A. Monitoring of irrigation fluid absorption during percutaneous nephrolithotripsy: the use of 1% ethanol as a marker. Anaesthesia. 2001;56(11):1103–6.PubMed
26.
Clarke K, Hall CL, Wiley Z, et al. Catheter-associated urinary tract infections in adults: diagnosis, treatment, and prevention. J Hosp Med. 2020;15(9):552–6.CrossRefPubMed
27.
Wagenlehner FM, Pilatz A, Naber KG, Weidner W. Therapeutic challenges of urosepsis. Eur J Clin Invest. 2008;38(Suppl 2):45–9.CrossRefPubMed
28.
Whiles BB, Deis AS, Simpson SQ. Increased time to initial antimicrobial administration is associated with progression to septic shock in severe sepsis patients. Crit Care Med. 2017;45(4):623–9.CrossRefPubMedPubMedCentral
29.
Nnaoma C, Chika-Nwosuh OZ, Isedeh A, Bustillo J, Al Twal A, Patel P. Venovenous extracorporeal membrane oxygenation in a gravid patient with acute respiratory distress syndrome: a case report. Am J Case Rep. 2019;20:705–8.CrossRefPubMedPubMedCentral
30.
Liu C, Sun W, Wang C, Liu F, Zhou M. Delivery during extracorporeal membrane oxygenation (ECMO) support of pregnant woman with severe respiratory distress syndrome caused by influenza: a case report and review of the literature. J Matern Fetal Neonatal Med. 2019;32(15):2570–4.CrossRefPubMed
31.
Zhu CY, Pan AJ, Mei Q, Chen T. Successful cure of a patient with urosepsis using a combination of extracorporeal membrane oxygenation and continuous renal replacement therapy: a case report and literature review. Chin J Traumatol. 2020;23(6):372–5.CrossRefPubMedPubMedCentral
32.
Chen H, Yu RG, Yin NN, Zhou JX. Combination of extracorporeal membrane oxygenation and continuous renal replacement therapy in critically ill patients: a systematic review. Crit Care. 2014;18(6):675.CrossRefPubMedPubMedCentral
33.
Villa G, Neri M, Bellomo R, et al. Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications. Crit Care. 2016;20(1):283.CrossRefPubMedPubMedCentral
34.
Fortenberry JD, Paden ML. Extracorporeal therapies in the treatment of sepsis: experience and promise. Semin Pediatr Infect Dis. 2006;17(2):72–9.CrossRefPubMed
35.
Shen G, He Y, Ni J, et al. Effects of comprehensive nursing on negative emotion and prognosis of patients with sepsis. Am J Transl Res. 2021;13(7):8221–7.PubMedPubMedCentral
Metadata
Title
Analysis of uroseptic shock after ureteroscopy for ureteral calculi during pregnancy: a case report
Authors
Wen Tang
Zhifei Xie
Mingwen Liu
ZeJu Zhao
Tao Wu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2023
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-023-01299-2

Other articles of this Issue 1/2023

BMC Urology 1/2023 Go to the issue

Case report

An abrupt decrease in arterial blood pressure may predict a high level carbon dioxide embolism in retroperitoneoscopic surgery: case report and a literature review

Case Report

Retroperitoneal urothelial carcinoma arising after bladder diverticulectomy: a case report

Research

Efficacy and safety of super-mini percutaneous nephrolithotomy in the treatment of urinary calculi: a systematic review and meta-analysis

Research

A prognostic model based on necroptosis-related genes for prognosis and therapy in bladder cancer

Research

Complications after partial nephrectomy: robotics overcomes open surgery and laparoscopy: the PMSI French national database

Research

Robot-assisted laparoscopic pyeloplasty is a valid option for ureteropelvic junction obstruction repair in adults with congenital renal abnormalities: a case series study