Maternal Sepsis

Sepsis is a leading cause of maternal death. Maternal sepsis usually occurs due to a severe bacterial infection of the uterus during pregnancy or immediately after childbirth. Though more common in developing countries, maternal sepsis is also prominent in developed countries, including the United States. According the Centers for Disease Control and Prevention, maternal sepsis causes 12.7% of pregnancy-related deaths in the United States. Despite being highly preventable, maternal sepsis continues to be a major cause of death and morbidity for pregnant or recently pregnant women.

Symptoms

  • Fever and chills
  • Dizziness
  • Lower abdominal pain
  • Foul-smelling vaginal discharge
  • Vaginal bleeding
  • Increased heart rate
  • Feelings of discomfort or illness

If you detect even a few of these symptoms, seek medical help immediately and ask, “could it be sepsis?”

Causes

Infections due to:

  • Mastitis (one or both breasts)
  • Miscarriage
  • Preterm delivery
  • Membrane rupture due to prolonged or obstructed labor
  • Cesarean/ C-section
  • Non-sterile abortion
  • Stillbirth
  • Multiple gestation (twins or more)
  • Pneumonia
  • Strep throat
  • Urinary Tract Infection

Risk Factors

  • Pregnancy
  • Diabetes
  • Cesarean/ C-section
  • In Vitro Fertilization
  • Amniocentesis
  • Chronic Villus Sampling (CVS)

Diagnosis

As with other forms of sepsis, diagnosing maternal sepsis can be difficult. Doctors often order multiple exams including blood tests to determine evidence of infection. They also check for abnormal vaginal discharge, edema and hypoglycemia among other symptoms. The key to early detection is to always be vigilant about the risk of maternal sepsis in all sick and pregnant women. Many hospitals are recommended to use a Modified Early Warning Scoring chart as maternal sepsis requires early detection and treatment.

Treatment

A variety of medications and procedures are used in treating maternal sepsis, including antibiotics to treat the infection, vasopressors to increase blood pressure, IV fluids and sometimes surgery. A multidisciplinary team including obstetricians, gynecologists, anesthetists and intensivists may be required for treatment. Early, aggressive treatment boosts the chances of surviving maternal sepsis.

Prevention

The most important factor in preventing maternal sepsis is to prevent and treat infections immediately and ensure clean birthing/delivery practices. Additionally, regular vaccinations and pre-natal care can lower the risk factors for maternal sepsis.