Sepsis

Research Article


Abstract views: 51 / PDF downloads: 37

Authors

  • Felis S

DOI:

https://doi.org/10.58372/2835-6276.1110

Keywords:

maternal mortality, maternal sepsis, sepsis, sequential organ failure assessment

Abstract

Maternal sepsis is "a life-threatening condition defined as an organ dysfunction caused by an infection during pregnancy, delivery, puerperium, or after an abortion," with the potential to save millions of lives if a proper approximation is made. Undetected or poorly managed maternal infections can lead to sepsis, death, or disability for the mother, and an increased likelihood of early neonatal infection and other adverse outcomes. Physiological, immunologic, and mechanical changes that occur in pregnancy make pregnant women more susceptible to infections than nonpregnant women and may obscure signs and symptoms of infection and sepsis, resulting in a delay in the recognition and treatment of sepsis. Prioritization of the creation and validation of tools that allow the development of clear and standardized diagnostic criteria of maternal sepsis and septic shock, according to the changes inherent to pregnancy, correspond to highly effective strategies to reduce the impact of these conditions on maternal health worldwide. After an adequate diagnostic approach, the next goal is achieving stabilization, trying to stop the progression from sepsis to septic shock, and improving tissue perfusion to limit cell dysfunction. Management protocol implementation during the first hour of treatment will be the most important determinant for the reduction of maternal mortality associated with sepsis and septic shock.

References

Fleischmann C, Scherag A, Adhikari NKJ, et al. Assessment of global incidence and mortality of hospital-treated sepsis: current estimates and limitations. Am J Respir Crit Care Med 2016;193:259-72.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014;DOI:10.1016/S2214-109X(14)70227-X.

Senior K. In the dark about sepsis. Lancet Infect Dis 2012;12:751-2.

Schutte JM, Steegers EA, Schuitemaker NW, Santema JG, de Boer K, Pel M, et al. Rise in maternal mortality in the Netherlands. BJOG 2010;117:399-406.

Acosta CD, Knight M, Lee HC, Kurinczuk JJ, Gould JB, Lyndon A. The continuum of maternal sepsis severity: incidence and risk factors in a population based cohort study. PLoS One. 2013;8:e67175.4.

Acosta CD, Kurinczuk JJ, Lucas DN, et al. Severe maternal sepsis in the UK, 2011-2012: a national case-control study. PLoS Med 2014;11:e1001672.

Rhodes A, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med 2017; 43:304-77.

Singer M, Deutschman CS, et al. The Sepsis Definitions Task Force Members. The Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3). Jama. February 2016,801-810.

WHO Statement on Maternal Sepsis. Geneva; 2017 [http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/] Accessed 17 February 2017.

Bonet M, Souza JP, Abalos E, Fawole B, Knight M, Kouanda S, Lumbiganon P, Nabhan A, Nadisauskiene R, Brizuela V, Metin Gülmezoglu A. The global maternal sepsis study and awareness campaign (GLOSS): study protocol. Reprod Health 2018; DOI:10.1186/s12978-017-0437-8.

Dolea C, Stein C. Global burden of maternal sepsis in the year 2000. Evidence and information for policy. World Health Organization, Ginevra, 2003.

Donati S. Dossier “La prevenzione e gestione della sepsi materna” in: Corso di Formazione a distanza: La prevenzione e gestione della sepsi materna – Italian Obstetric Surveillance System - Istituto Superiore di Sanità; ZADIG Editore - 0ttobre 2018

World Health Organization Statement on Maternal Sepsis. Ginevra, 2017.

Royal College of Obstetricians and Gynaecologists. Bacterial sepsis in pregnancy, Green top Guideline N. 64a –2012.

National Institute for Health and Care Excellence (NICE) Clinical guideline, Postnatal care up to 8 weeks after birth, 2015

Sistema nazionale linee guida (SNLG), Istituto superiore di sanità (ISS). Gravidanza fisiologica Linea guida 20. Roma, ISS, 2016.

Macias AE, et al. for the Global Influenza Initiative. The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza. Influenza Other Respir Viruses 2015;9:S31-7.

Ministero della Salute Dipartimento della Programmazione e dell’Ordinamento del Servizio Sanitario Nazionale Direzione Generale della Programmazione Sanitaria Ufficio III ex D.G.Prog. Manuale di formazione per il governo clinico: la sicurezza dei pazienti e degli operatori. 2012.

AGENAS. Linee di indirizzo per la prevenzione delle complicanze in gravidanza. Agenzia Nazionale Per i Servizi Sanitari Regionali, 2017.

Committee on Obstetric Practice. ACOG Committee Opinion No 732 Influenza vaccination during pregnancy Obstet Gynecol 2018; 131:e109-14.

World Health Organization fact sheet on influenza, WHO 2018.

Agenzia Italiana del Farmaco - AIFA htp://www.aifa.gov.it/content/oms-nuove-linee-guida-la-prevenzione-e-il trattamento- delle- infezioni- nel- periodo- del- peripartum

The Joint Commission. Preventing maternal death. Sentinel Event Alert. 2010;1-4.

Mackintosh N, Watson K, et al. Value of a modified early obstetric warning system (MEOWS) in managing maternal complications in the peripartum period: an ethnographic study. BMJ Qual Saf. 2014; 23:26-34.

Singh S, McGlennan A, England A, Simons R. A validation study of the CEMACH recommended modified early obstetric warning system. Anaesthesia 2012; 67:12-18.

Knight M, Nair M, Tufnell D, Shakespeare J, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2013-15. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2017.

Chebbo A, Tan S, Kassis C, Tamura L, Carlson RW. Maternal sepsis and septic shock. Critical Care Clinics 2016; 32: 119-135.

Royal College of Obstetricians and Gynaecologists. Bacterial sepsis following pregnancy, Green top Guideline N. 64b, 2012.

Axelsson D, Blomberg M. Maternal obesity, obstetric interventions and post-partum anemia increase the risk of post-partum sepsis: a population-based cohort study based on Swedish medical health registers. Infect Dis, London, 2017.

Karlsson E, et al. Review of the impact of pregnancy and obesity on influenza virus infection. Influenza Other Respir Virus 2012; 6:449e60.

Smaill FM, Grivell RM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.:CD007482.

Lavi Oud, Pregnancy-associated severe sepsis: contemporary state and future challenges. Infect Dis Ther 2014; 3:175-89.

Elton RJ, Chaudhari S. Sepsis in obstetric. Continuing Education in Anaesthesia, Critical Care & Pain, 2015.

Palaniappan N, Menezes M, Wilson P. Group A streptococcal puerperal sepsis: management and prevention. Obstet Gynaecol 2012; 14:9-16.

Epicentro, 2016. htp://www.epicentro.iss.it/problemi/listeria/listeria.asp

Burney LE. Influenza immunization: statement. Public Health Rep 1960; 75:944.

Lamont RF, Sobel JD, et al. Varicella-zoster virus (chickenpox) infection in pregnancy. BJOG 2011; 118:1155-62.

Buist S, Mapp CE. Respiratory Diseases in Women. European Respiratory Society. 2003; Vol.8: Monograph 25.

Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345:1368-77.

Rivers EP, Katranji M, Jaehne KA, et al. Early interventions in severe sepsis and septic shock: a review of the evidence one decade later. Minerva Anestesiol 2012; 78:712-24.

Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004 Mar;32(3):858-73.

Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36(1):296-327.

Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock 2012. Critical Care Med. 2013; 41:580-637. Intensive Care Medicine. 2013; 39:165-227.

Levy MM, Rhodes A, Phillips GS, et al. Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study. Crit Care Med 2015; 43:3-12.

Arora KS, Shields LE, Grobman WA, D’Alton ME, Lappen JR, Mercer BM. Triggers, bundles, protocols, and checklists. What every maternal care provider needs to know. Am J Obstet Gynecol 2016; 214:444-51.

Brown KN, Arafeh JMR. Obstetric sepsis: focus on the 3-hour bundle. J Perinat Neonatal Nurs 2015; 29:213-21.

Robson WP, Daniels R. The Sepsis Six: helping patents to survive sepsis. Brit J Nurs 2008; 17:16-21.

Albright CM, Ali TN, Lopes V, Rouse DJ, Anderson BL. Lactic acid measurement to identify risk of morbidity from sepsis in pregnancy. Am J Perinatol 2015; 32:481-6.

Gilbert David N, Eliopoulos George M, Chambers Henry F, Saag Michael S, Pavia Andrew T (Editor). The Sanford Guide to Antimicrobial Therapy 2018 48th Edition

Ferrer R, Martn-Loeches I, Phillips G, Osborn TM, Townsend S, Dellinger RP, Artgas A, Schorr C, Levy MM. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program. Crit Care Med 2014; 42:1749-55.

Guyat G, Akl E, Crowther M, Holger J, et all Antithrombotic therapy and prevention of thrombosis,9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

National Collaborating Centre for Women’s and Children’s Health. Intrapartum care: Care of healthy women and their babies during childbirth. London, RCOG Press, 2007.

Sameshima H, Ikenoue T, Ikeda T, Kamitomo M, Ibara S. Association of non-reassuring fetal heart rate patterns and subsequent cerebral palsy in pregnancies with intrauterine bacterial infection. Am J Perinatol 2005; 22:181-7.

Ugwumadu A. Understanding cardiotocographic patterns associated with intrapartum fetal hypoxia and neurologic injury. Best Pract Res Clin Obstet Gynaecol 2013; 27:509-36.

Ugwumadu A. Are we (mis)guided by current guidelines on intrapartum fetal heart rate monitoring? Case for a more physiological approach to interpretation. BJOG 2014; 121:1063-70.

Chandraharan E. Handbook of CTG interpretation: from patterns to physiology. Cambridge University Press, 2017.

American College of Obstetricians and Gynaecologists Commitee on Obstetric Practice. ACOG Practice Bullettin No. 100: Critical care in pregnancy. Obstet Gynecol 2009; 113:443-50.

Shefeld JS. Sepsis and septic shock in pregnancy. Crit Care Clin 2004; 20:651-60.

Downloads

Published

2023-11-25

How to Cite

Felis S. (2023). Sepsis: Research Article. American Journal of Medical and Clinical Research & Reviews, 2(12), 1–22. https://doi.org/10.58372/2835-6276.1110

Issue

Section

Articles