Sepsis and pregnancy, Sepsis occurs as the result of a systemic maladaptive inflammatory response to an infectious insult. It is the leading cause of mortality in intensive care units (ICUs) in developed countries and the incidence is increasing worldwide . Sepsis is also one of the leading causes of maternal mortality . The incidence of death from severe sepsis in the obstetric population is lower than that of non-obstetric patients. The latter is likely secondary to a younger population with less coexisting medical pathologies. Pregnancy affects both humoral and cell-mediated immunological functions. The white blood cell count rises as pregnancy progresses, and some authors have described these neutrophils as “activated,” favoring severe inflammatory reactions to infectious stimuli . Cellular immunity is compromised as a consequence of the decline in T-helper type 1 and natural killer cells. The decrease in cellular immunity predisposes pregnant women to infections from viruses and parasites. In contrast, antibody-mediated immunity is enhanced in pregnancy despite the fact that levels of immunoglobulins are depressed (likely from hemodilution). Pregnancy is not a state of generalized immunosuppression, instead, it is a state of immunomodulation, with compromised cellular and enhanced humoral immunity.
|Original language||English (US)|
|Title of host publication||Maternal Critical Care|
|Subtitle of host publication||A Multidisciplinary Approach|
|Publisher||Cambridge University Press|
|Number of pages||10|
|State||Published - Jan 1 2011|
ASJC Scopus subject areas