title: Puerperal sepsis.
abstract: Infections during pregnancy are relatively prevalent, and the majority of cases are managed well in the community. Occasionally, however, infections may be life-threatening. Sepsis may be associated with multiple organ dysfunction and a high mortality. The treatment of sepsis is time critical and requires early fluid resuscitation and antibiotics. Early involvement of other specialties and allied health-care professionals to provide a multidisciplinary approach to patient care is important. Continuous monitoring of maternal vital signs and provision of supportive care for multiple organ dysfunction are best done within the intensive care unit. Despite advances in patient care, the mortality rate associated with maternal sepsis remains high. Health-care services in low-income countries face particular problems that account for an increased incidence of puerperal sepsis and maternal mortality. These include lack of access to health care, septic abortions and a greater incidence of human immunodeficiency virus. The key to management of sepsis is early recognition, aggressive resuscitation, antibiotic administration and source control.
authors.affiliation: Bloomsbury Institute of Intensive Care Medicine, University College London, Cruciform Building, Gower Street, London WC1E 6BT, UK. Electronic address: nish_arul@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Arulkumaran
authors.forename: M
authors.initials: M
authors.lastname: Singer
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis* / Q000628:therapy*; D003422:Critical Care; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D042241:Early Diagnosis; D005260:Female; D005440:Fluid Therapy; D014943:Global Health / Q000706:statistics & numerical data; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000628:therapy; D011645:Puerperal Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012772:Shock, Septic / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: intensive care; resuscitation; sepsis