It may not be something that is commonly talked about when it comes to maternal, fetal and infant health, but maternal sepsis should be on everyone's radar according to many health experts.
Maternal sepsis is a rare but serious and life-threatening complication that occurs during pregnancy or postpartum. It accounts for 12.7 per cent of pregnancy-related deaths in the United States alone each year. When many people think of sepsis, they may think of it as the poisoning of the body, but there's actually a little more to it than that.
Sepsis is the body's severe response to an infection. It develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body, instead of fighting off the invader. This is known as septic shock, which is a medical emergency. It can cause blood pressure to drop and damage to multiple organs - sometimes leading to death.
The good news is that according to The World Health Organization, maternal sepsis is very preventable, however, more needs to be done to ensure the health and safety of new mothers and their babies. Early intervention and timely access to the right medication is crucial, and so are proper prevention and control in hospitals and clinics.
Having a correct diagnosis is also high on this list, and according to a study recently published in Anesthesia & Analgesia, some of the current tests used to detect sepsis may not be doing their job. According to Melissa Bauer, D.O., many clinicians have difficulty diagnosis sepsis in labouring women because many of the signs of infection can be altered in pregnancy - including temperature, blood pressure and respiratory rate.
"Currently, there are no good ways to identify these women early," she said. "We're working on figuring out the best way to do that."
One of the ways Bauer and her team of researchers took this on was by analyzing medical records over the past two decades to see which of the three commonly used sepsis screening tools do the best job in diagnosing the condition. What they found was these screening tools had very different sensitivities (the ability to identify patients with a particular condition) and specificities (the ability to identify patients without a particular condition). They discovered that the Systemic Inflammatory Response Syndrome (SIRS) tool had the best sensitivity overall.
"In my opinion, it is better for a test to have a higher sensitivity so that anyone with sepsis is caught,” said Bauer, adding that specificity is still important and ideally, there needs to be a balance.
For now, vigilance remains the best way to a timely and correct diagnosis of sepsis in mothers and postpartum women. Maternal sepsis can be treatable if caught, and Bauer's study clearly showed that better systems need to be in place to meet this need.