title: Sepsis during pregnancy.
abstract: OBJECTIVE
  To provide a current review of the literature regarding the assessment and management of sepsis during pregnancy.
  
  
  METHODS
  A comprehensive review of current English-language literature search was performed with Ovid MEDLINE using the Medical Subject Headings pregnancy and sepsis, with Medical Subject Headings or keywords seeking randomized controlled trials and clinical reports, and by reviewing the bibliographies of clinical practice guidelines.
  
  
  RESULTS
  Sepsis-related maternal morbidity and mortality is a significant and persistent problem in the modern critical care obstetric unit. The management of sepsis during pregnancy is challenging. The obstetric intensivist must simultaneously discern the effect of maternal physiologic changes on fetal vulnerability and the effect of the fetus on maternal status throughout the various phases of pregnancy. Little direct evidence exists to validate the extrapolation of some sepsis treatment modalities from other nonpregnant patient populations. Nevertheless, early detection, accurate diagnosis, and aggressive appropriate treatment strategies may significantly improve outcome. Approaches like the Surviving Sepsis Campaign guidelines are unproven but seem reasonable and practical.
  
  
  CONCLUSIONS
  Sepsis during pregnancy is uncommon yet potentially fatal. Diagnostic and therapeutic guidelines should predominantly pattern those currently utilized for nonpregnant patients.
authors.affiliation: Multidisciplinary Critical Care Medicine Fellowship Program, Mayo Foundation, Rochester, MN, USA.
authors.forename: Evans R
authors.initials: ER
authors.lastname: Fernández-Pérez
authors.forename: Salam
authors.initials: S
authors.lastname: Salman
authors.forename: Shanthan
authors.initials: S
authors.lastname: Pendem
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Farmer
mesh_terms: D003422:Critical Care; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*