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Maternal Sepsis Review and Update.

Fadi B Yahya1, Amy L Van Abel2, Benjamin D Brakke3

  • 1Department of Obstetrics & Gynecology, Mayo Clinic Health System, Albert Lea, MN.

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|July 3, 2025
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Summary
This summary is machine-generated.

Maternal sepsis is a growing threat, now the second leading cause of preventable maternal death. This update offers guidance on maternal sepsis screening and management, aligning with new CMS initiatives for improved patient outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Public Health

Background:

  • Maternal sepsis is a significant and increasing cause of preventable maternal mortality.
  • The Centers for Medicare and Medicaid Services (CMS) has introduced the Severe Sepsis/Septic Shock Management Bundle (SEP-1) to enhance sepsis care.
  • SEP-1 will be integrated into the Hospital Value-Based Purchasing program by 2026, emphasizing the need for updated clinical practices.

Purpose of the Study:

  • To provide an updated overview of maternal sepsis definitions, screening protocols, and management strategies.
  • To align clinical practices with recent CMS guidance and initiatives.
  • To address early detection and management in both outpatient and inpatient settings.

Main Methods:

  • Comprehensive literature search across PubMed, Google Scholar, Scholar GPT, and Google for national and international guidelines.
  • Focused literature searches on maternal sepsis review articles and early warning tools.
  • Development of a 3-stage screening/diagnostic framework and a care process model.

Main Results:

  • A 3-stage screening and diagnostic framework for maternal sepsis is proposed.
  • A care process model for initial maternal sepsis management, aligned with CMS guidance, is presented.
  • Alternative treatment regimens for peripartum infections and β-lactam allergies are suggested based on updated standards.

Conclusions:

  • Early detection and prompt management of maternal sepsis are critical in all care settings.
  • Adherence to updated guidelines and proposed frameworks can improve sepsis care and reduce maternal mortality.
  • Comprehensive post-discharge follow-up is essential for optimal recovery and long-term outcomes.