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Maternal sepsis

new concepts, new practices

Foeller, Megan E.; Gibbs, Ronald S.

Current Opinion in Obstetrics and Gynecology: February 14, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/GCO.0000000000000523
REVIEW: PDF Only

Purpose of review 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.

Recent findings 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.

Summary 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.

Stanford University School of Medicine, Stanford, California, USA

Correspondence to Megan E. Foeller, MD, Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA. E-mail: mfoeller@stanford.edu

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