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Severe Maternal Morbidity Due to Sepsis

The Burden and Preventability of Disease in New Zealand

Lepine, S.; Lawton, B.; Geller, S.; Abels, P.; MacDonald, E.J.

doi: 10.1097/01.aoa.0000575144.22305.60
Mechanisms, Equipment, Hazards
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(Aust N Z J Obstet Gynaecol. 2018;58:648–653)

Obstetric sepsis is a common cause of severe maternal morbidity (SMM) in New Zealand with its incidence appearing to be on the rise. Physiological changes of pregnancy and labor analgesia may sometimes mask symptoms of sepsis, making diagnosis of sepsis in parturients more difficult than in nonpregnant patients. Pregnancy also alters the immune system, leading to varied responses to infection. To diagnose sepsis in a more timely fashion and improve patient outcomes, obstetricians and anesthesiologists should have a low index of suspicion for sepsis in pregnant and postpartum women who present with signs of fever, tachycardia, dyspnea and other symptoms that could suggest sepsis. Over the past few years there has been the introduction of care bundles throughout medicine which are meant to improve the recognition, diagnosis, and management of sepsis. This article aimed to describe the degree of severe morbidity caused by obstetric sepsis in New Zealand, with special attention focused on possible methods of prevention.

RANZCOG, Wellington Regional Hospital, Wellington, New Zealand

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