Maternal Sepsis: Presentation, Course, Treatment, and Outcomes

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Critical Care Medicine

Background:

• The 1992 adult definition of sepsis and septic shock is inadequate for pregnant and peripartum women due to altered clinical presentations.
• Maternal sepsis poses significant risks, contributing to morbidity and mortality.

Purpose of the Study:

• To identify causative factors of sepsis in pregnant and peripartum women.
• To inform prevention strategies and reduce maternal morbidity and mortality.

Main Methods:

• Retrospective medical record review of 22 women diagnosed with sepsis post-admission.
• Study conducted in the labor and delivery unit of a large urban hospital.

Main Results:

• Common diagnoses included urinary tract infections, endometritis, chorioamnionitis, and wound infections.
• Predominant causative agents were Escherichia coli (E. coli), group B streptococcus (GBS), and group A streptococcus.
• Key symptoms were hypothermia/hyperthermia and tachycardia; lab findings included abnormal white blood cell counts and elevated lactate.
• Sixty-four percent of sepsis patients were readmitted postpartum; 41% delivered via cesarean.

Conclusions:

• Findings support the development of nursing care protocols for maternal sepsis.
• Early identification tools and risk assessment are crucial for reducing maternal morbidity and mortality.
• Educating new mothers and families on early warning signs is vital for timely medical intervention.