Maternal sepsis update

Abstract

Purpose of reviewMaternal sepsis is the second leading cause of maternal death in the United States. A significant number of these deaths are preventable and the purpose of this review is to highlight causes such as delays in recognition and early treatment. Recent findingsMaternal sepsis can be difficult to diagnose due to significant overlap of symptoms and signs of normal physiological changes of pregnancy, and current screening tools perform poorly to identify sepsis in pregnant women. Surveillance should not only include during pregnancy, but also throughout the postpartum period, up to 42 days postpartum. Education and awareness to highlight this importance are not only vital for obstetric healthcare provides, but also for nonobstetric healthcare providers, patients, and support persons. SummaryThrough education and continual review and analysis of evidence-based practice, a reduction in maternal morbidity and mortality secondary to maternal sepsis should be attainable with dedication from all disciplines that care for obstetric and postpartum patients. Education and vigilance also extend to patients and support persons who should be empowered to escalate care when needed.

Resuscitation in obstetric care

“…41 Overall, maternal sepsis remains a leading cause of maternal death and contributes to severe maternal morbidity. 39 Common causes of sepsis in the antepartum period include pneumonia, genitourinary tract infection, and chorioamnionitis. In the intrapartum and postpartum periods, pelvic causes of sepsis dominate, with the most common etiologies being endometritis, wound infection, and genitourinary.…”

“…This makes prompt treatment difficult. The incidence of maternal sepsis likely ranges between 1:2000 and 1:4000 deliveries in the United States, and recent data suggest that this number may be increasing 39–41 . Despite this increase, mortality from sepsis has decreased over the past several years 41 .…”

“…Despite this increase, mortality from sepsis has decreased over the past several years 41 . Overall, maternal sepsis remains a leading cause of maternal death and contributes to severe maternal morbidity 39 …”

“…The incidence of maternal sepsis likely ranges between 1:2000 and 1:4000 deliveries in the United States, and recent data suggest that this number may be increasing. [39][40][41] Despite this increase, mortality from sepsis has decreased over the past several years. 41 Overall, maternal sepsis remains a leading cause of maternal death and contributes to severe maternal morbidity.…”

Pregnancy Outcomes in Patients with Urosepsis and Uncomplicated Urinary Tract Infections—A Retrospective Study

“…Management of maternal urosepsis includes early antibiotic initiation, fluid resuscitation, and administration of vasopressors [35]. A prompt recognition of maternal urosepsis is extremely important in order to prevent adverse pregnancy outcomes, such as preterm birth and perinatal mortality [36,37].…”