13. Sepsis in Obstetrics and Gynaecology Flashcards
Sepsis
Infection plus systemic manifestations of infection
Severe sepsis
Sepsis plus sepsis-induced organ dysfunction or tissue hypoperfusion
Septic shock
Persistence of hypoperfusion despite adequate fluid replacement therapy
Sepsis symptoms:
Fever, vomiting, diarrhoea, abdominal pain, tachycardia, non-blanching rash, offensive vaginal discharge, urinary symptoms, tachypnoea
Risk factors for sepsis:
- Obesity
- DM
- Immunosuppression
- Anaemia
- Pelvic infection
- Group B Strep
- Prolonged spontaneous rupture of membranes
Septic shock steps:
Volume of blood in intravascular system is lower than the capacity of vascular bed low blood pressure and reduced tissue perfusion.
- Hypoxia and tissue death
- Organ failure
- Coma, death
Septic shock in pregnancy:
Reduction in placental perfusion, hypotension -> adverse effects on foetus, requires continuous foetal monitoring
PPROM definition
Preterm Prelabour Rupture of the Membranes
Chorioamnionitis
Inflammation of the amniochorionic membranes due to microbial invasion (Mainly due to ascending infection)
Causes for chorioamnionitis:
Infections – mycoplasmas, E.coli, group B strep, Anaerobic bacteria
Risk factors for chorioamnionitis:
- PPROM
- Prolonged labour
- Multiple digital examinations
- Nulliparous
- Epidural
- Alcohol and smoking
Signs and symptoms of chorioamnionitis:
- Maternal pyrexia
- Maternal tachycardia
- Uterine tenderness
- Offensive vaginal discharge
- Foetal tachycardia
Chorioamnionitis management:
- Broad spectrum IV Abx
- Paracetamol and hydration
- Deliver bebo
- FBC, blood cultures, vaginal swabs, MSU
Implications of chorioamnionitis for mother:
- Increased risk of C section
- Endometritis
- Wound infection
- PPH
- Sepsis, Death
Implications of chorioamnionitis of bebo:
- Sepsis, death
- Asphyxia
- Pneumonia
- Intraventricular haemorrhage
