Sepsis in pregnancy

Sepsis in pregnancy

Sepsis is defined as an infection that reaches blood stream and causes systemic manifestations with possible multiorgan failure.

Pregnant women are known to be immunocompromised and hence are at higher risk of sepsis.

Factors in pregnancy that increase the risk of sepsis:

** diabetes

**prolonged rupture of membranes

**invasive procedures

**recurrent vaginal bleeding

**foul smelling vaginal discharge

**pregnant ladies are generally immunocompromised

Assessment of patients with suspected sepsis:

**history taking focusing on recent contact with sick individuals

**physical examination looking for: skin rash, cyanosis, breach of skin integrity and looking for sources of infection that might need drainage

**vital signs: temperature, pulse rate, oxygen saturation, blood pressure

**blood tests

**imaging of body cavities looking for a source of infection that needs surgical intervention

Note that alteration of mental status is a red flag in sepsis

Blood tests to be done in sepsis:

management of pregnant ladies with sepsis:

Note that the antibiotic can be changed according to the culture results.

What is the target oxygen saturation?

94-98%

Does sepsis need early delivery or termination of pregnancy?

** early delivery can be considered if the maternal condition is deteriorating in order to save the fetus if viable

** early delivery can be considered if the infection was inside the uterus

** termination of pregnancy can be considered if the source of infection is the pregnancy tissue

Consultant Obstetrician, Gynecologist and Infertility Specialist