Identification and Management of Sepsis in Pregnancy

Maternal sepsis, especially puerperal sepsis, is a common pregnancy-related condition and in the United States (US) is a leading cause of maternal mortality, accounting for 13% of maternal deaths and up to 15% of maternal admissions to the intensive care unit (ICU), with a cause-specific mortality ratio of 2.2 deaths per 100,000 live births (1–6). Especially concerning is that sepsis has been increasingly reported as the cause of maternal death, rising by up to 10% per year between 2000 and 2010 (3,7). This is due, in part, to a greater than 200% increase in the incidence of pregnancy-associated severe sepsis over that same time period in parts of the US (8).

Maternal sepsis is also associated with an increase in fetal morbidity including increased risk of preterm delivery, low birth weight, and perinatal mortality. In fact, fetal mortality approaches 33% in the setting of maternal sepsis requiring ICU admission (9–12).