Sepsis in Obstetrics: Pathophysiology and Diagnostic Definitions

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Infectious Diseases

Background:

• Sepsis presents diagnostic and therapeutic challenges, particularly in the obstetric population.
• The pathophysiology of sepsis involves a complex, overactive inflammatory response that is not fully elucidated.
• Current diagnostic criteria for systemic inflammatory response syndrome and sepsis lack specific considerations for the physiological changes in pregnancy.

Discussion:

• This article initiates a three-part series on sepsis and septic shock in pregnancy.
• It delves into the proposed pathophysiology of sepsis and introduces updated definitions for sepsis and septic shock.
• Understanding these new definitions and underlying mechanisms is vital for clinical practice.

Key Insights:

• Pregnancy-specific criteria for sepsis are currently lacking.
• Physiological adaptations during pregnancy complicate sepsis diagnosis.
• Revised definitions aim to improve sepsis recognition in pregnant individuals.

Outlook:

• Further research is needed to refine sepsis diagnostic criteria for pregnant and peripartum women.
• Implementing updated definitions can enhance early sepsis identification and management.
• This work serves as a foundation for improving sepsis outcomes in the obstetric population.