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Maternal sepsis: new concepts, new practices.

Megan E Foeller1, Ronald S Gibbs

  • 1Stanford University School of Medicine, Stanford, California, USA.

Current Opinion in Obstetrics & Gynecology
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PubMed
Summary

Sepsis during pregnancy is a major cause of maternal death. Early recognition and prompt treatment, including antibiotics and fluids, are crucial for improving survival rates in obstetric patients.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Sepsis is a significant contributor to maternal morbidity and mortality.
  • Pregnancy-related sepsis presents diagnostic challenges for clinicians.
  • Recent guideline revisions emphasize early recognition and intervention.

Purpose of the Study:

  • To review current understanding and management of sepsis in pregnancy.
  • To highlight the importance of early detection and treatment protocols.
  • To emphasize the role of obstetricians in managing maternal sepsis.

Main Methods:

  • Review of recent Surviving Sepsis Campaign and WHO guidelines (2016-2017).
  • Analysis of clinical decision tools for sepsis recognition in obstetric populations.

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  • Discussion of essential treatment components: antibiotics, fluid resuscitation, and source control.

    • Main Results:

    • No optimal screening tool currently exists for obstetric sepsis.
    • Timely administration of antibiotics (within 1 hour) and fluid resuscitation is critical.
    • Escalation of care and source control are vital components of management.

    Conclusions:

    • Clinicians should maintain a low threshold for evaluating and treating suspected sepsis in pregnant patients.
    • Incorporating updated sepsis definitions and treatment guidelines into practice is essential.
    • Multidisciplinary care coordination by obstetricians is key to improving outcomes.