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.