Maternal Sepsis: Current Approaches to Recognition and Clinical Management

Sepsis represents a leading cause of maternal morbidity and mortality in the United States and worldwide. Clinical management of sepsis in pregnancy must take into consideration the unique pathophysiology of pregnancy. Etiologies of sepsis in pregnant and post-partum women differ from a patient who is non-pregnant. Moreover, the clinical diagnosis of sepsis in pregnancy can be quite challenging due to the anticipated physiologic changes that occur in pregnancy, contributing to variability in recognition. Pre-existing maternal medical conditions and other demographic factors may also predispose certain women to developing sepsis. Prompt recognition and subsequent treatment of sepsis in pregnancy can improve both maternal and neonatal outcomes. In the present review, we will summarize the perinatal implications of sepsis in the obstetric population during the antepartum and postpartum periods. Further understanding of systemic inflammation leading to multi-system organ failure, non-obstetric and obstetric etiologies of sepsis, and subsequent perinatal complications will help to expeditiously identify and treat women with this life-threatening condition to ultimately improve outcomes.