Early Recognition and Management of Maternal Sepsis

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Infectious Diseases

Background:

• Septic shock during pregnancy, though rare, is a significant cause of maternal mortality.
• Perinatal patients can deteriorate rapidly from sepsis to septic shock.
• Early goal-directed therapy is crucial for managing sepsis.

Purpose of the Study:

• To evaluate compliance with early goal-directed therapy (EGDT) for sepsis.
• To assess the impact of a standardized physician order set and interprofessional education on EGDT compliance.
• To improve sepsis management and reduce maternal mortality.

Main Methods:

• Retrospective study of 97 women with positive sepsis screening from April 2014 to January 2015.
• Comparison of pre-intervention and post-intervention compliance with sepsis bundles.
• Analysis of key EGDT components including lactate testing and antibiotic administration.

Main Results:

• Significant improvement in blood lactate level testing (p = .029) and repeat lactate testing (p = .034).
• Increased administration of broad-spectrum antibiotics (p = .006), particularly in severe sepsis and septic shock (p = .010).
• Demonstrated enhanced compliance with sepsis bundles post-intervention.

Conclusions:

• A standardized sepsis protocol and interprofessional education improve compliance with sepsis bundles.
• Multidisciplinary approaches are effective in enhancing sepsis care during the perinatal period.
• Improved adherence to sepsis bundles can lead to better maternal health outcomes.