Maternal Sepsis Flashcards
1
Q
Causes of sepsis in pregnancy
A
Chorioamnionitis
Urinary tract infections
2
Q
Chorioamnionitis
A
Infection of the chorioamniotic membranes and amniotic fluid
3
Q
Presentation of chorioamnionitis
A
Abdominal pain
Uterine tenderness
Vaginal discharge
4
Q
Presentation of a UTI
A
Dysuria Urinary frequency Suprapubic pain or discomfort Renal angle pain (with pyelonephritis) Vomiting (with pyelonephritis)
5
Q
MEOWS chart
A
Maternity early obstetric warning system
6
Q
Investigations for maternal sepsis
A
FBC
U&Es - kidney function and for acute kidney injury
LFTs - liver function and as a possible source of infection (e.g. acute cholecystitis)
CRP
Clotting - DIC
Blood cultures - bacteraemia
Blood gas - lactate, pH and glucose
Additional investigations based on the suspected source of infection:
- Urine dipstick and culture
- High vaginal swab
- Throat swab
- Sputum culture
- Wound swab after procedures
- Lumbar puncture for meningitis or encephalitis
7
Q
Management
A
- A-E
- Get senior input
- Sepsis 6
- CTG monitoring
- Emergency Caesarean section may be indicated (using general anaesthetic)
- Follow local guidelines abx - tazocin + gentamicin
8
Q
Sepsis 6
A
Blood lactate level Blood cultures Urine output Oxygen to maintain oxygen saturations 94-98% Empirical broad-spectrum antibiotics IV fluids
