Sepsis in pregnancy | Cheat Sheet

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

51

Pages:

5
Author:

Mariam A. A.

Sepsis in Pregnancy The third most common direct cause if direct cause of maternal mortality May arise anytime during antenatal, intrapartum and postnatal period To maintain an effective pregnancy ->need to turn down the immune system -> immune compromise -> increased risk of sepsis There is an increased risk of trauma -> increased risk of sepsis Lots of VE -> increase risk From pregnancy related complications -> higher sepsis risk Lactate – marker for severity The six things: Lactate IV fluids IV antibiotics Urine output + urine analysis Important because it shows kidney failure We do a UTI test and ask about features on every visit because it is common to develop in pregnancy . Any infection and since the woman is immunocompromised because she is pregnant -> increased risk of sepsis 30% of women have asymptomatic bacteriuria Risk of going to the kidney and causing pyelonephritis On of the early sign -> hence important to recognise Cultures Vitals Causes of maternal sepsis Most common: UTI Pyelopnheiris Pelvic sutures -> chornioamntis , endometritis Surgical wounds -> c sections and perinteal lacterations Breast -> mastitis Others: Infection at cannula site Septic abortion Intrauterine deaths Acute appendicitis Acute cholecystitis Pancreatitis Necrotizing fasciitis Pneumonia Causes Common E. coli Most important one Most commonly from pyelonephritis GAS GBS Most commonly in children -> they spread it The most common pathogen that causes death Most commonly from vagina Klebsiella S. aureus Most commonly from breast Anaerobes -> pepstrpetoccoi Others Listeria -> avoidance of soft cheese, or found that has been left open Viral causes -> influenza, varicella, hepatitis, bacteruides , Clostridium , CMV Malaria RF C section Vaginal trauma, wound hematoma Hence important to get both high and low swaps For every site that you swap, should use a different swap Because every site has different pathogens that may be the cause Risk of cross contamination Prolonged labour Retained products Poor personal hygiene Poor hand washing Obesity Diabetes Anaemia Cervical cerclage History of pelvic infections Vaginal discharge Traumatic birth -> instrumental Features -> many of the features already happen in pregnancy and in post-partum so these may make sepsis worse and/or may cause it to be missed /masked especially in the young and healthy Tachycardia Hypotension Clampy Dyspnoea Fever Hence for any pregnant woman presenting to ED being unwell swap at lots of places, as there is a high chance that it is sepsis History of coughing Flu like symptoms Vomit or diarrhoea Possible intrauterine infection e.g. PROM or RPOC New onset confusion Urinary features Possible breast infection Unexplained abdominal pain or distension SIRS criteria Management