Abstract
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 [1]. Sepsis is also one of the leading causes of maternal mortality [2]. 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 [3]. 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) |
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Title of host publication | Maternal Critical Care |
Subtitle of host publication | A Multidisciplinary Approach |
Publisher | Cambridge University Press |
Pages | 346-355 |
Number of pages | 10 |
ISBN (Electronic) | 9781139088084 |
ISBN (Print) | 9781107018495 |
DOIs | |
State | Published - Jan 1 2011 |
ASJC Scopus subject areas
- General Medicine