Acute chorioamnionitis complicated with symmetrical peripheral gangrene

• Main Authors: Yi-Tzu Chu, Alan Hsu, Chia-Chieh Wu, Horng-Der Tsai, Charles Tsung-Che Hsieh, Yi-Hsuan Hsiao
• Format: Article
• Language: English
• Published: Elsevier 2020-11-01
• Series: Taiwanese Journal of Obstetrics & Gynecology
• Subjects: Symmetrical peripheral gangrene; Septic shock; Disseminated intravascular coagulation; Preterm premature rupture of membranes
• Online Access: http://www.sciencedirect.com/science/article/pii/S1028455920302436

Objective: Symmetrical peripheral gangrene (SPG) is an uncommon but important clinical syndrome. We present a case of acute chorioamnionitis complicated with SPG. Case report: A 33-year-old female (gravida 5, para 2) was admitted with preterm premature rupture of membranes (PPROM) at 20 weeks and four days of gestation. She received cervical cerclage four days ago. Seven days after the diagnosis of PPROM, she developed fever, tachypnea and tachycardia. Termination of pregnancy was decided for clinical diagnosis of sepsis. After the abortus was born, gangrene change on the nose was noticed. Afterwards, this patient developed acrocyanosis of extremities. SPG developed following sepsis with intravascular disseminated coagulation (DIC). After intensive care, the patient underwent hyperbaric oxygen therapy and fasciectomy of the left forearm. Conclusion: We suggest awareness of SPG associated with acute chorioamnionitis. Early recognition of SPG, multidisciplinary care, and treatment of its underlying conditions are the mainstays of management.