Sepsis is defined as an acute inflammatory response syndrome secondary to an
infectious focus. It has a high incidence, morbidity and mortality, causing
substantial financial costs, especially due to complications such as septic shock and
multiple organ dysfunction. The pathogen toxins associated with individual
susceptibility culminate with cytokine release, which promotes a systemic
inflammatory response that can progress to multiple organ dysfunction and eventual
patient death.Specifically, sepsis incidence, morbidity and mortality are lower in pregnant women,
as this group is typically younger with fewer comorbidities having a polymicrobial
etiology resulting in sepsis.Pregnant women exhibit physiological characteristics that may confer specific
clinical presentation and laboratory patterns during the sepsis course. Thus, a
better understanding of these changes is critical for better identification and
management of these patients. The presence of a fetus also requires unique approaches
in a pregnant woman with sepsis.Sepsis treatment is based on certain guidelines that were established after major
clinical trials, which, unfortunately, all classified pregnancy as a exclusion
criteria.Thus, the treatment of sepsis in the general population has been extrapolated to the
pregnant population, with the following main goals: maintenance of tissue perfusion
with fluid replacement and vasoactive drugs (initial resuscitation), adequate
oxygenation, control of the infection source and an early start of antibiotic
therapy, corticosteroid infusion and blood transfusion when properly indicated,
prophylaxis, and specifically monitoring and maintenance of fetal heath.