Maternal sepsis is an evolving challenge
Turner, Michael J.
Despite major advances in the last century, particularly in high resource settings, maternal
sepsis remains a common and potentially preventable cause of direct maternal death
globally. A barrier to further progress has been the lack of consensus on the definition of
maternal sepsis. Publications from two recent multidisciplinary consensus conferences,
one on sepsis in the non-pregnant
adult and the other on sepsis in the pregnant woman,
concluded that the criteria for diagnosing sepsis should be clinically-based,
applicable at
the bedside, and should not be laboratory-based.
Informed by reviews of the evidence,
in 2017 WHO published a new definition of maternal sepsis based on the presence of
suspected or confirmed infection. It also announced a Global Maternal and Neonatal
Sepsis Initiative to identify the diagnostic criteria for the early identificati on, epidemiology,
and disease classification of maternal sepsis. Standardizing the criteria for maternal
sepsis optimizes clinical audit and research. It may facilitate the evaluation of the role
of different clinical parameters and biomarkers in the diagnosis, earlier recognition and
management of maternal infection and sepsis. Further work is required to develop an
international consensus on the criteria for diagnosing maternal sepsis and any associated
organ dysfunction.
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