Progressive multiple organ dysfunction syndrome in adolescent pregnancy: Case report.

Area of Science:

• Obstetrics and Gynecology
• Nephrology
• Intensive Care Medicine

Background:

• Adolescent pregnancy, while physiological, carries risks of premature delivery and severe maternal/neonatal pathologies.
• Pyelonephritis and sepsis during pregnancy can precipitate acute complications, including multiple organ dysfunction syndrome (MODS).

Observation:

• A 14-year-old adolescent at 27 weeks gestation presented with preterm labor, pyelonephritis, and acute kidney injury, rapidly progressing to septic shock and MODS.
• Despite intensive care, including mechanical ventilation and dialysis, the patient developed sustained organ failure over 28 days.
• Preterm vaginal delivery occurred, resulting in a neonate with severe asphyxia, bronchopulmonary dysplasia, and hypoxic-ischemic encephalopathy.

Findings:

• The adolescent developed chronic kidney disease stage KDIGO 5 and requires renal transplantation.
• The case highlights the severe, progressive nature of MODS in complicated adolescent pregnancies.
• Neonatal complications included severe asphyxia and hypoxic-ischemic encephalopathy.

Implications:

• Timely diagnosis and management of pyelonephritis and septic shock in adolescent pregnancies are critical.
• Preventing delays in treatment can avert mortality and permanent sequelae for both mother and child.
• This case underscores the need for high-risk obstetric monitoring and intensive care for complicated adolescent pregnancies.