Sepsis In Pregnancy

In pregnant women the signs and symptoms of sepsis may be less distinctive than in the non-pregnant population and are not necessarily present in all cases; a high index of suspicion is necessary

Clinical features suggestive of sepsis:

  • Fever or rigors
  • Diarrhoea or vomiting – may indicate exotoxin production (early toxic shock)
  • Rash (generalised streptococcal maculopapular rash or purpura fulminans)
  • Abdominal / pelvic pain and tenderness
  • Offensive vaginal discharge (odour suggests anaerobes; serosanguinous suggests streptococcal infection)
  • Productive cough
  • Urinary symptoms

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Diagnostic criteria for sepsis:

  • suspected or documented infection associated with some of the following variables
    • Fever (>38°C)
    • Hypothermia (core temperature <36°C)
    • Tachycardia (>100 beats per minute)
    • Tachypnoea (>20 breaths per minute)
    • Impaired mental state
    • Significant oedema or positive fluid balance (>20ml/kg over 24 hours)
    • Hyperglycaemia in the absence of diabetes (plasma glucose >7.7 mmol/l)

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RCOG Green Top Guidance; Sepsis in Pregnancy

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