By: 1 March 2013

Severity and death rates are increasing in pregnant and postpartum women with sepsis, and more than 30 percent of mothers who develop sepsis will experience some type of organ dysfunction.

In the UK, maternal deaths related to sepsis are increasing, and it is currently one of the leading causes of death in pregnant or postpartum women.

“The importance of this research is that it helps define the problem of sepsis during pregnancy,” said Melissa E. Bauer, D.O., University of Michigan, Department of Anaesthesiology. “The more we know about this disease, the more we will be able to do to help prevent, diagnose and treat it.”

To determine the incidence, severity of the disease in those affected, quantify how many deaths are related to sepsis, and determine risk factors for sepsis, the study used a database representing 44 million patients over 11 years.

The results of the study, presented at the ANESTHESIOLOGY 2012 annual meeting, revealed:

•    The incidence of sepsis is approximately 1:3,300 during hospitalisation for childbirth
•    An estimated 1:10,000 deliveries will be complicated by sepsis, leading to organ system dysfunction
•    About 1:100,000 will die from sepsis during hospitalisation for childbirth

Identifying risk factors for sepsis is an important process to help guide physicians to more closely monitor those at an elevated risk. Certain conditions may be associated with an elevated risk for sepsis, including medical conditions such as chronic congestive heart failure, chronic liver disease, chronic kidney disease, lupus and HIV. All women, especially women with these conditions, should be educated about the signs of infection and precautions to take.

“Pregnant patients are at a higher risk for infection than the general population,” added Dr Bauer. “The most common infections that may be causing these severe infections are urinary tract infections, pneumonia and chorioamnionitis (infection of the membranes and amniotic fluid). As infection worsens, it could lead to sepsis.”

Clinical signs of sepsis include low temperature, fever, rapid heart rate, low blood pressure, rapid breathing rate, low oxygen level, changes in mental status and decreased urine output.