SMFM Consult Series #47: Sepsis during pregnancy and the puerperium

Society for Maternal-Fetal Medicine (SMFM) pubs@smfm.org Society for Maternal-Fetal Medicine: Publications Committee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Maternal sepsis is a significant cause of maternal morbidity and mortality and is a preventable cause of maternal death. The purpose of this guideline is to summarize what is known about sepsis and to provide guidance for the management of sepsis in pregnancy and the postpartum period. The following are SMFM recommendations: (1) we recommend that sepsis and septic shock be considered medical emergencies and that treatment and resuscitation begin immediately (GRADE 1B); (2) we recommend that providers consider the diagnosis of sepsis in pregnant patients with otherwise unexplained end-organ damage in the presence of an infectious process, regardless of the presence of fever (GRADE 1B); (3) we recommend that empiric broad-spectrum antibiotics be administered as soon as possible, ideally within 1 hour, in any pregnant woman in whom sepsis is suspected (GRADE 1B); (4) we recommend obtaining cultures (blood, urine, respiratory, and others as indicated) and serum lactate levels in pregnant or postpartum women in whom sepsis is suspected or identified, and early source control should be completed as soon as possible (GRADE 1C); (5) we recommend early administration of 1–2 L of crystalloid solutions in sepsis complicated by hypotension or suspected organ hypoperfusion (GRADE 1C); (6) we recommend the use of norepinephrine as the first-line vasopressor during pregnancy and the postpartum period in sepsis with persistent hypotension and/or hypoperfusion despite fluid resuscitation (GRADE 1C); (7) we recommend against immediate delivery for the sole indication of sepsis and that delivery should be dictated by obstetric indications (GRADE 1B).

Original languageEnglish (US)
Pages (from-to)B2-B10
JournalAmerican journal of obstetrics and gynecology
Volume220
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Postpartum Period
Sepsis
Pregnancy
Resuscitation
Hypotension
Pregnant Women
Maternal Death
Emergency Treatment
Maternal Mortality
Septic Shock
Obstetrics
Cause of Death
Lactic Acid
Norepinephrine
Fever
Mothers
Urine
Guidelines
Anti-Bacterial Agents
Morbidity

Keywords

  • maternal sepsis
  • pregnancy-associated sepsis
  • sepsis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Society for Maternal-Fetal Medicine (SMFM) pubs@smfm.org Society for Maternal-Fetal Medicine: Publications Committee (2019). SMFM Consult Series #47: Sepsis during pregnancy and the puerperium. American journal of obstetrics and gynecology, 220(4), B2-B10. https://doi.org/10.1016/j.ajog.2019.01.216

SMFM Consult Series #47 : Sepsis during pregnancy and the puerperium. / Society for Maternal-Fetal Medicine (SMFM) pubs@smfm.org Society for Maternal-Fetal Medicine: Publications Committee.

In: American journal of obstetrics and gynecology, Vol. 220, No. 4, 01.04.2019, p. B2-B10.

Research output: Contribution to journalArticle

Society for Maternal-Fetal Medicine (SMFM) pubs@smfm.org Society for Maternal-Fetal Medicine: Publications Committee 2019, 'SMFM Consult Series #47: Sepsis during pregnancy and the puerperium', American journal of obstetrics and gynecology, vol. 220, no. 4, pp. B2-B10. https://doi.org/10.1016/j.ajog.2019.01.216
Society for Maternal-Fetal Medicine (SMFM) pubs@smfm.org Society for Maternal-Fetal Medicine: Publications Committee. SMFM Consult Series #47: Sepsis during pregnancy and the puerperium. American journal of obstetrics and gynecology. 2019 Apr 1;220(4):B2-B10. https://doi.org/10.1016/j.ajog.2019.01.216
Society for Maternal-Fetal Medicine (SMFM) pubs@smfm.org Society for Maternal-Fetal Medicine: Publications Committee. / SMFM Consult Series #47 : Sepsis during pregnancy and the puerperium. In: American journal of obstetrics and gynecology. 2019 ; Vol. 220, No. 4. pp. B2-B10.
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