title: Sepsis in Pregnancy: Identification and Management.
abstract: Sepsis accounts for up to 28% of all maternal deaths. Prompt, appropriate treatment improves maternal and fetal morbidity and mortality. To date, there are no validated tools for identification of sepsis in pregnant women, and tools used in the general population tend to overestimate mortality. Once identified, management of pregnancy-associated sepsis is goal-directed, but because of the lack of studies of sepsis management in pregnancy, it must be assumed that modifications need to be made on the basis of the physiologic changes of pregnancy. Key to management is early fluid resuscitation and early initiation of appropriate antimicrobial therapy directed toward the likely source of infection or, if the source is unknown, empiric broad-spectrum therapy. Efforts directed at identifying the source of infection and appropriate source control measures are critical. Development of an illness severity scoring system and treatment algorithms validated in pregnant women needs to be a research priority.
authors.affiliation: Departments of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (Drs Albright, Rouse, and Hughes); and Women's Medicine, Division of Obstetric Medicine (Dr Mehta), Women & Infants Hospital, Brown University, Providence, Rhode Island.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Albright
authors.forename: Niharika D
authors.initials: ND
authors.lastname: Mehta
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Brenna L
authors.initials: BL
authors.lastname: Hughes
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D019468:Disease Management; D042241:Early Diagnosis; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing
chemical_list: D000890:Anti-Infective Agents