Sepsis in pregnancy background

Question 1

Risk factors for sepsis

Answer 1

• Obesity
• Impaired glucose tolerance / diabetes
• Impaired immunity/ immunosuppressant medication
• Anaemia
• Vaginal discharge
• History of pelvic infection
• History of group B streptococcal infection
• Amniocentesis and other invasive procedures
• Cervical cerclage
• Prolonged spontaneous rupture of membranes
• GAS infection in close contacts / family members
• Of black or other minority ethnic group origin

Question 2

Clinical signs suggestive of sepsis

Answer 2

• Pyrexia
• Hypothermia
• Tachycardia
• Tachypnoea
• Hypoxia
• Hypotension
• Oliguria
• Impaired consciousness
• Failure to respond to treatment
• Nausea, vomiting and diarrhoea
• Exquisite severe pain out of proportion to clinical signs due to necrotising fasciitis
• Watery vaginal discharge
• Generalised rash
• Conjunctival suffusion
• Offensive vaginal discharge (smelly suggests anaerobes; serosanguinous suggests streptococcal infection)
• Productive cough
• Urinary symptoms