Maternal sepsis: new concepts, new practices

Current Opinion in Obstetrics & Gynecology
Megan E Foeller, Ronald S Gibbs

Abstract

Sepsis is a leading cause of severe maternal morbidity and maternal death. As pregnancy-related sepsis can be difficult to recognize, clinicians should maintain a low threshold for early evaluation and treatment. Definitions and treatment guidelines for maternal sepsis were recently revised in 2016 and 2017 by the Surviving Sepsis Campaign and WHO. Multiple clinical decision tools have been created to aid clinicians in early recognition and risk prediction for sepsis in obstetric populations, but currently, an optimal screening tool does not exist. Early recognition and urgent treatment is paramount for patient survival. Antibiotics should be started within 1 h and fluid resuscitation should be initiated if sepsis-induced hypoperfusion is present. Care should be escalated to appropriate settings and source control provided. Obstetricians have a heightened understanding of the physiologic changes in pregnancy and play a vital role in coordinating patient care and improving outcomes. The recent 2016 and 2017 revisions of definitions for maternal sepsis and treatment should be incorporated into clinical practice.

References

Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Apr 20, 2004·Critical Care Medicine·R Phillip DellingerUNKNOWN Surviving Sepsis Campaign Management Guidelines Committee
Oct 29, 2008·Clinics in Chest Medicine·Sean R TownsendR Phillip Dellinger
May 5, 2009·Acta Obstetricia Et Gynecologica Scandinavica·Hannah M C KramerJos van Roosmalen
Aug 24, 2012·Obstetrics and Gynecology·John R Barton, Baha M Sibai
Oct 19, 2012·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Candice C SnyderBaha M Sibai
Jan 29, 2013·Critical Care Medicine·R Phillip DellingerUNKNOWN Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup
Feb 28, 2013·Critical Care Medicine·David F GaieskiBrendan G Carr
May 3, 2014·Obstetrics and Gynecology·William A GrobmanUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU)
Jul 9, 2014·PLoS Medicine·Colleen D AcostaUNKNOWN United Kingdom Obstetric Surveillance System
Aug 12, 2014·The Lancet Global Health·Lale SayLeontine Alkema
Sep 10, 2014·Infectious Diseases and Therapy·Lavi Oud
Oct 2, 2014·The New England Journal of Medicine·Sandra L PeakePatricia Williams
Oct 3, 2014·Critical Care Medicine·Mitchell M LevyR Phillip Dellinger
Jan 23, 2015·Obstetrics and Gynecology·Patrick J MaguireMichael J Turner
Mar 18, 2015·The New England Journal of Medicine·Paul R MounceyUNKNOWN ProMISe Trial Investigators
Jul 28, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·O Mohamed-AhmedM Knight
Sep 9, 2015·Obstetrics and Gynecology·Melissa E BauerFrank W J Anderson
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
Oct 30, 2016·International Journal of Obstetric Anesthesia·G AbirB Carvalho
Jan 19, 2017·Critical Care Medicine·R Phillip DellingerMitchell M Levy
Jan 20, 2017·Intensive Care Medicine·Andrew RhodesR Phillip Dellinger
Feb 22, 2017·The Lancet Global Health·UNKNOWN Global Maternal and Neonatal Sepsis Initiative Working Group. Electronic address: bonetm@who.int
Mar 23, 2017·The New England Journal of Medicine·UNKNOWN PRISM InvestigatorsDonald M Yealy
May 23, 2017·The New England Journal of Medicine·Christopher W SeymourMitchell M Levy
Jul 4, 2017·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Lucy BowyerAngela Makris
Jul 12, 2017·Obstetrics and Gynecology·Andreea A CreangaWilliam M Callaghan
Sep 9, 2017·Obstetrics and Gynecology·Catherine M AlbrightBrenna L Hughes
Dec 23, 2017·Journal of Thoracic Disease·Hawa Edriss
Feb 1, 2018·Reproductive Health·Mercedes BonetA Metin Gülmezoglu
Mar 27, 2018·British Journal of Anaesthesia·C C FranklingF Gao
May 17, 2018·Critical Care Medicine·Mitchell M LevyAndrew Rhodes

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Citations

Jul 28, 2020·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·R Douglas Wilson

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