Maternal sepsis

Am J Obstet Gynecol MFM. 2020 Aug;2(3):100149. doi: 10.1016/j.ajogmf.2020.100149. Epub 2020 Jun 29.

Abstract

Maternal sepsis is "a life-threatening condition defined as an organ dysfunction caused by an infection during pregnancy, delivery, puerperium, or after an abortion," with the potential to save millions of lives if a proper approximation is made. Undetected or poorly managed maternal infections can lead to sepsis, death, or disability for the mother, and an increased likelihood of early neonatal infection and other adverse outcomes. Physiological, immunologic, and mechanical changes that occur in pregnancy make pregnant women more susceptible to infections than nonpregnant women and may obscure signs and symptoms of infection and sepsis, resulting in a delay in the recognition and treatment of sepsis. Prioritization of the creation and validation of tools that allow the development of clear and standardized diagnostic criteria of maternal sepsis and septic shock, according to the changes inherent to pregnancy, correspond to highly effective strategies to reduce the impact of these conditions on maternal health worldwide. After an adequate diagnostic approach, the next goal is achieving stabilization, trying to stop the progression from sepsis to septic shock, and improving tissue perfusion to limit cell dysfunction. Management protocol implementation during the first hour of treatment will be the most important determinant for the reduction of maternal mortality associated with sepsis and septic shock.

Keywords: maternal mortality; maternal sepsis; sepsis; sequential organ failure assessment.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Infant, Newborn
  • Maternal Mortality
  • Pre-Eclampsia*
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Sepsis* / diagnosis
  • Shock, Septic* / diagnosis