Maternal sepsis update: current management and controversies
File(s)
Accepted version
Author(s)
Greer, Orene
Shah, Nishel Mohan
Johnson, Mark R
Type
Journal Article
Abstract
•Sepsis is a leading cause of maternal morbidity and mortality, globally and in the UK.
•In pregnancy and the puerperium, women may be more susceptible to rapid deterioration of illness following an infection.
•Sepsis has a complex pathophysiology and the immunological and cardiovascular adaptations of normal pregnancy may have an adverse impact on the maternal response to infection. Furthermore, physiological changes of pregnancy, which mimic those of sepsis, often delay optimal management.
•‘Bedside’ identification of pathogens and their antibiotic resistance patterns may help to improve clinical outcomes.
•Recent updates in sepsis management, areas of controversy and the importance of translational research and clinical trials for pregnancy and the puerperium are discussed.
•In pregnancy and the puerperium, women may be more susceptible to rapid deterioration of illness following an infection.
•Sepsis has a complex pathophysiology and the immunological and cardiovascular adaptations of normal pregnancy may have an adverse impact on the maternal response to infection. Furthermore, physiological changes of pregnancy, which mimic those of sepsis, often delay optimal management.
•‘Bedside’ identification of pathogens and their antibiotic resistance patterns may help to improve clinical outcomes.
•Recent updates in sepsis management, areas of controversy and the importance of translational research and clinical trials for pregnancy and the puerperium are discussed.
Date Issued
2020-01
Date Acceptance
2019-05-31
Citation
The Obstetrician & Gynaecologist, 2020, 22 (1), pp.45-55
ISSN
1467-2561
Publisher
Wiley
Start Page
45
End Page
55
Journal / Book Title
The Obstetrician & Gynaecologist
Volume
22
Issue
1
Copyright Statement
© 2019 Royal College of Obstetricians and Gynaecologists. This is the accepted version of the following article: Greer, O. , Shah, N. M. and Johnson, M. R. (2019), Maternal sepsis update: current management and controversies. Obstet Gynecol. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/tog.12623
Identifier
https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/tog.12623
Subjects
Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
biomarkers
extracorporeal membranous oxygenation
lactate
maternal sepsis
steroids
GOAL-DIRECTED RESUSCITATION
REGULATORY T-CELLS
SEPTIC SHOCK
IMMUNE TOLERANCE
PREGNANCY
LEVOSIMENDAN
MORBIDITY
MORTALITY
PREVENTION
COUNTRIES
1114 Paediatrics and Reproductive Medicine
Publication Status
Published
Article Number
tog.12623
Date Publish Online
2019-11-12