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Maternal Medicine Posters
The “sepsis six” elements of care of the first “golden” hour of resuscitation - a need for increased awareness amongst obstetricians
  1. A Uku,
  2. C Candelier,
  3. A Green
  1. Stepping Hill Hospital, Stockport, Manchester, United Kingdom

Abstract

In the UK, sepsis is now the leading cause of direct maternal deaths. To reduce mortality, immediate aggressive treatment in the first hour of resuscitation is vital.

Our objective was to ascertain our maternity unit's compliance with the “Sepsis Six” elements of care from our local Trust guidelines.

Results Over a twelve-month period, 104 women were identified with sepsis using the Severe Sepsis Screening Tool with data analysis performed on 37 randomly selected women - 49% developed sepsis antenatally and 51% postpartum. A third of women diagnosed postpartum were delivered by caesarean section, with over 80% by emergency section.

No women had the required 2 sets of blood cultures before administering antibiotics. 86.5% of women were prescribed iv antibiotics. Of these, 53.1% received the first dose within the first hour. Only 75% of prescribed antibiotics were as per Trust guideline. All women had FBC, 54% U&E, 19% coagulation studies, and 11% lactate levels taken. No women had a blood glucose taken. 48.6% women had MSSU sent for C&S. 89.2% of women received intravenous fluids and 2.7% received 100% oxygen therapy.

Conclusion Our study shows a lack of adherence to the “Sepsis Six” care pathway to be followed during the first “golden hour” of resuscitation. Poor compliance with existing Trust guidelines is partly due to lack of obstetric staff awareness. To address this need, a care pathway for the management of suspected severe sepsis in the childbearing continuum has been developed – a necessary tool to ensure best care provision.

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