Maternal sepsis is a severe, life-threatening condition that can occur during pregnancy, childbirth, or in the postpartum period. It arises when the body’s response to an infection causes injury to its own tissues and organs. This complication poses a significant risk to maternal health, making early recognition and appropriate management crucial for positive outcomes.
Defining Maternal Sepsis
Maternal sepsis is defined as organ dysfunction resulting from an infection during pregnancy, childbirth, post-abortion, or up to 42 days postpartum. It occurs when the body’s immune system, in its attempt to fight an infection, inadvertently causes widespread inflammation and damage to its own tissues and organs, which can progress rapidly.
Infections that can lead to maternal sepsis are varied and not always pregnancy-related. Common sources include bacterial infections of the uterus, often following C-sections or perineal tears. Other infections, such as urinary tract infections (UTIs), pneumonia, or strep throat, can also escalate to sepsis in pregnant or postpartum individuals. Physiological changes during pregnancy can make individuals more susceptible to infections and may mask early signs.
Sepsis begins with an infection, triggering a systemic inflammatory response. Uncontrolled, this can lead to severe sepsis, characterized by organ dysfunction. The most severe stage, septic shock, involves a dangerous drop in blood pressure and inadequate blood flow to organs, increasing the risk of multi-organ failure and death.
Recognizing the Signs
Recognizing the signs of maternal sepsis can be challenging because some symptoms may overlap with normal pregnancy changes or postpartum discomfort. Prompt identification is important for timely intervention. Symptoms can include a fever or chills, or an unusually low body temperature.
Other indicators include changes in vital signs like a rapid heart rate (tachycardia) and rapid breathing (tachypnea). Low blood pressure, confusion, or disorientation may also occur. Physical signs can include clammy or mottled, or discolored skin.
Significant pain or discomfort, particularly in the lower abdomen, is another sign. Reduced urine output, foul-smelling vaginal discharge, or unusual vaginal bleeding can also indicate a progressing infection. Any of these symptoms, especially when combined, warrant immediate medical attention.
Diagnosis and Treatment
Diagnosis involves clinical assessment and laboratory tests. Healthcare providers will evaluate symptoms and conduct physical examinations. Blood tests identify signs of infection, inflammation markers like C-reactive protein (CRP) or procalcitonin (PCT), and indicators of organ dysfunction.
Urine tests and wound cultures may pinpoint the source of infection. Imaging techniques, such as ultrasound or CT scans, help locate the infection’s origin if not immediately apparent. Early and accurate diagnosis is important as immediate treatment improves outcomes.
Treatment involves rapid administration of broad-spectrum antibiotics. Intravenous fluids support blood pressure and improve blood flow to organs. Medications to stabilize blood pressure (vasopressors) and support organ function may be necessary. Identifying and addressing the infection’s source, such as draining an abscess or removing infected tissue, is a further management step.
Preventive Measures and Risk Factors
Preventive measures focus on reducing the risk of infection and promoting overall health. Maintaining good hygiene practices, especially hand washing and proper wound care after delivery, helps prevent infections. Completing full courses of prescribed antibiotics ensures complete pathogen eradication.
Attending prenatal and postpartum appointments allows healthcare providers to monitor for potential infections and address concerns early. Staying up-to-date on routine vaccinations, such as the flu shot, reduces the risk of infections that could lead to sepsis.
Several factors increase susceptibility to maternal sepsis. Pre-existing medical conditions like diabetes or obesity are associated with higher risk. Pregnancy-related factors include prolonged rupture of membranes (when the water breaks long before labor), multiple vaginal examinations during labor, and invasive procedures such as C-sections or amniocentesis. A weakened immune system or conditions like mastitis (breast infection) also contribute to the risk.