RT Book, Section
A1 Saade, George R.
A2 Foley, Michael R.
A2 Strong, Jr., Thomas H.
A2 Garite, Thomas J.
SR Print(0)
ID 1115790664
T1 Maternal Sepsis
T2 Obstetric Intensive Care Manual, 4e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071820134
LK obgyn.mhmedical.com/content.aspx?aid=1115790664
RD 2024/10/06
AB Sepsis,  severe  sepsis,  and  septic  shock  are  a  continuum  in  the  systemic  response  to  infection.  Sepsis  is  the  leading  cause  of  mortality  in  intensive  care  units  and  accounts  for  10%  of  direct  maternal  deaths  in  North  America.  Most  deaths  in  sepsis  are  due  to  multiple  organ  dysfunction  syndrome  (MODS),  the  final  stage  in  the  sepsis  spectrum.  The  obstetric  patient  is  particularly  vulnerable  to  sepsis  because  of  the  association  between  pregnancy  and  infectious  complications  such  as  pyelonephritis,  chorioamnionitis,  endometritis,  wound  infection,  necrotizing  fascitis,  and  cholecystitis.  Septic  shock  occurs  in  up  to  4%  of  bacteremic  patients,  and  40%  to  60%  of  patients  in  septic  shock  have  bacteremia.  The  relationship  between  bacteremia  and  sepsis  also  depends  on  other  contributing  factors,  such  as  immune  suppression,  and  associated  medical  conditions.  Overall,  gram-negative  aerobic  bacilli  used  to  be  the  predominant  organisms  associated  with  sepsis.  However,  the  incidence  of  infection  with  gram-positive  organisms  in  patients  with  sepsis  has  increased  and  may  now  equal  that  of  gram-negative  infections.