Abstract

Obstetric sepsis and septic shock remain among the most dangerous forms of critical illness in pregnant and postpartum women. The disease becomes particularly severe when acute respiratory distress syndrome develops, reflecting not only primary injury to the alveolar–capillary membrane but also systemic inflammatory dysregulation, endothelial dysfunction, coagulopathy, capillary leak, and multiple organ dysfunction. This review summarizes current concepts regarding the pathogenesis, diagnosis, and intensive care of ARDS in obstetric sepsis. Particular attention is paid to lung-protective respiratory support, early antimicrobial therapy, source control, hemodynamic stabilization, fluid and transfusion strategies, the use of glucocorticoids and antifungal agents, prevention of thromboembolic complications, and the role of extracorporeal techniques. Internationally recommended doses and the doses of key medications used in Russian clinical guidelines are presented separately. It is emphasized that treatment of ARDS in postpartum women with sepsis should not be based on isolated correction of hypoxemia, but rather on a comprehensive strategy that includes early recognition of sepsis, immediate initiation of therapy, source control, and continuous reassessment of organ dysfunction.
 

Keywords

obstetric sepsis postpartum sepsis septic shock acute respiratory distress syndrome postpartum women intensive care mechanical ventilation antibiotics norepinephrine hydrocortisone.

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