Sepsis in Pregnancy

Sepsis in pregnancy has been identified by the World Health Organization (WHO) as the third leading cause of maternal death worldwide after hemorrhage and hypertensive disorders. While there has been considerable research interest and monetary investment in sepsis research over the past 20 years, no trial to date has included the pregnant and post-partum populations. Providers must have an understanding of the normal physiologic changes that occur during pregnancy, i.e., leukocytosis, decreased blood pressure, and increased cardiac output, that can make the diagnosis of sepsis in pregnancy less obvious. These normal variations provide a challenge to the bedside clinician as the common screening tools utilized (SIRS criteria, qSOFA) will be positive during a healthy pregnancy. Additionally, providers need to have a high index of suspicion for obstetric specific complications and their treatments.