Maternal Sepsis: Prevention and early detection strategies

Maternal sepsis is a major cause of maternal mortality and morbidity worldwide, particularly in low- and middle-income countries. It is a life-threatening condition that occurs when an infection during pregnancy, childbirth, or the postpartum period leads to a systemic inflammatory response. Timely detection and prevention are critical to reducing the incidence and improving outcomes in pregnant women

● Monitoring and screening: To identify early sepsis signs, regular checkups and lab tests are essential.Monitoring vital signs like fever, heart rate, breathing rate, and white blood cell count is especially important for women with higher risk factors for complications. By monitoring these parameters, potential health issues can be detected and addressed promptly.
● Early warning scores: Using maternal early warning scores (MEWS) can help detect sepsis early. These systems use clinical parameters to identify women at risk of deterioration, allowing for timely intervention.
● Rapid testing: Advances in point-of-care testing have made rapid diagnosis of infections possible. Tests such as lactate measurement and procalcitonin levels can help identify sepsis quickly, even before symptoms become severe.

● Prenatal care: Regular prenatal checkups are essential for identifying risks, and providing timely support and care.
Vaccination: It's crucial to stay up-to-date on vaccinations before and while expecting to prevent infection risks. Vaccination against certain infections, such as influenza and pertussis, can protect pregnant women from severe illnesses that may lead to sepsis.
● Hygiene and infection control: Proper hygiene practices, including hand washing and aseptic techniques, are essential during labor and delivery. Healthcare facilities must adhere to strict infection control measures to minimize hospital-borne infections.
● Nutritional support: Adequate nutrition strengthens the immune system, reducing susceptibility to infections. Iron and folic acid supplements can prevent anemia, which is a risk factor for maternal sepsis
● Manage health conditions: Health conditions like diabetes can be more prone to Maternal sepsis. Expectant mothers should Inform their care team if they notice any health changes
Conclusion
Maternal sepsis is a condition associated with high mortality, is very difficult to diagnose but is a preventable and treatable condition. In some cases, physiological changes during pregnancy may delay the initiation of critical interventions to reduce mortality, which may lead to the deterioration of the patient's condition. By implementing comprehensive prevention strategies, including antenatal care, hygiene practices, education, and nutritional support, and by enhancing early detection through surveillance, early warning scores, early identification, and point-of-care testing, the risk of maternal sepsis can be substantially reduced.
(Author: Dr. Teena Thomas, MBBS, MRCOG, PGDMNC, PGDFM, Apollo Cradle & Children’s Hospital, Marathahalli, Bangalore)