Sepsis and Pregnancy & Childbirth

Although pregnancy is the same for women worldwide, their safety varies greatly depending on where the women live and the type of medical care they receive, if any.

Sepsis is an illness that can develop in some pregnant women, as well as in women who have recently delivered a baby or babies. Sepsis that occurs during pregnancy is called maternal sepsis. If it develops within six weeks of delivery, it is called postpartum sepsis or puerperal sepsis. Sometimes called blood poisoning, sepsis is the body’s often deadly inflammatory response to infection. Sepsis kills and disables millions, more than breast cancer, lung cancer, and stroke combined.

Maternal and postpartum sepsis are more common in the developing countries, but they also do strike women in the wealthier countries, including in the United States. In the mid-90s, sepsis was responsible for about 7.6% of maternal deaths in the U.S. And while pregnancy-associated sepsis is not as common in American hospitals as it used to be decades ago, it is still potential deadly and requires early detection, accurate diagnosis, and aggressive treatment. In fact, a new study published in October 2013 reported that severe sepsis and sepsis-related deaths are actually rising in the U.S. The study also reports that “Sepsis is currently the leading cause of direct maternal death in the United Kingdom.”

How Does Sepsis Occur in Pregnant and Postpartum Women?

Sepsis can occur because of an infection related to the pregnancy or one that is totally unrelated, such as pneumonia or a urinary tract infection (UTI). An article published by the American College of Emergency Physicians in 2012, said that women with maternal sepsis can make up as many as 30% of pregnancy-related sepsis cases admitted to intensive care units in countries like the U.S. The authors found that the most common infections that triggered maternal sepsis were caused by bacteria such as E. coli.

Sepsis can develop as the result of many complications. Here are just a few:

  • Miscarriages (spontaneous abortions) or induced abortions: Infections are a risk after any miscarriage or abortion. Non-sterile abortions,those that may be done outside of a healthcare facility, are a particular risk. Women who have had one should watch for signs and symptoms of an infection (lasting or increasing pain, discolored or odorous (smelly) discharge, abdominal tenderness, high temperature, fatigue, feeling unwell).
  • Cesarean sections: Sepsis can set in after any type of surgery. Cesarean sections are major abdominal surgeries with all the associated risks. See Sepsis and Surgery for more information.
  • Prolonged or obstructed labor: An unusually long time of labor or labor that stops progressing.
  • Ruptured membranes: The longer the period between the “water breaking” and the baby’s birth, the higher the chance of an infection.
  • Infection following vaginal delivery: Although not common in the developed world among women who give birth in healthcare facilities, infections are very common in the developing world.
  • Mastitis: Infection in the breasts can trigger sepsis.
  • Viral or Bacterial Illnesses: Any illness that raises the risk of sepsis in the general population will do so in pregnant women as well. For example, see: Sepsis and InfluenzaSepsis and HIV/AIDS and Sepsis and MRSA