A research team hopes to help physicians save lives through early identification and treatment of maternal sepsis.
Pregnancy carries many risks for mom. Leading causes of maternal death in the US are:
- Cardiovascular disease
- Non-cardiovascular disease
- Sepsis or other infection
- Hemorrhage
Around the world, sepsis is responsible for 15 percent of maternal deaths. In the US, sepsis is responsible for almost 13 percent of deaths suffered by pregnant or post-partum women, according to the Centers for Disease Control and Prevention (CDC).
Sepsis: Overwhelming Immune Response
Your immune system works 24/7 to protect your health, and identify and disable foreign microbes. It is responsible for healing after illness or injury, among other functions. Sometimes, when your body encounters an infection, the immune system triggers a response so large that the inflammatory fight harms body tissue and internal organs. This overwhelming immune response is sepsis.
Because the pregnant body undergoes many changes as a baby grows or is delivered, warning signs of sepsis can be missed by healthcare practitioners. Scientists from the University of Michigan collaborated with institutions across the country and Israel to try and identify screening practices and tools that have the best chance of revealing maternal sepsis in its early stages.
Dr. Melissa Bauer, with Michigan Medicine, worked on the team that delivers its findings in the journal Anesthesia and Analgesia. She notes, “A lot of the things you depend on to tell you there’s an infection can be altered in pregnancy. Those include a patient’s vital signs such as heart rate, blood pressure and white blood cell count.”
By reviewing the medical records of women who suffered maternal mortality, researchers looked at three diagnostic assessments commonly used to evaluate for sepsis. Those tools are:
- Maternal Early Warning (MEW) criteria: These criteria are used to identify women at risk for sepsis, hemorrhage, and other maternal complications
- Quick Sequential Organ Failure Assessment: Intended to identify patients with suspected infections, this tool missed about 50 percent of sepsis cases
- Systemic Inflammatory Response Syndrome: This assessment tool defines criteria used to diagnose sepsis, and has been in use since 1992
As research advances on the cause and treatment of sepsis, one common point applies to sepsis in pregnant women and the general public—sepsis must be caught early in order to survive the infection without lifetime disability or death.
Rapid Development Demands Rapid Response
In their analysis, scientists determined that slightly more than eight percent of women who received appropriate antibiotics within an hour of diagnosis with sepsis died. Twenty percent of women who were not provided the right antibiotics within that first hour died.
Researchers underscore the importance of taking the vital signs of pregnant and laboring women frequently. Given the rapid development of sepsis, the study authors note that good maternal care is critical. States Dr. Baur, “We need physicians to take a good, long look at the patient and make sure that vital signs are reassessed frequently, because things can change quickly.”
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