Sepsis is the leading cause of direct maternal deaths in the UK. The 2011 Confidential Enquiries into Maternal Deaths Report recommends early recognition and aggressive antibiotic treatment as key measures that help save lives. It is vital to identify the source of infection rapidly and within the first 6 hours of presentation. The Report findings prompted an audit of our maternity unit's current practice in the management of sepsis.
Results The records of 37 women were randomly selected from 104 women identified with sepsis in pregnancy or within 6 weeks of delivery using the “Severe Sepsis Screening Tool” during a twelve-month study period. Compliance with the Trust Guidelines on Management of Severe Sepsis and Septic Shock was audited. Cause of sepsis was unknown in 13 (35%) women with the leading identified causes being chorioamnionitis (7), wound infection (5) and endometritis (3). Although blood cultures were taken in all women, no women had 2 sets taken as per guideline recommendation. Ten (27%) women were given antibiotics before blood cultures were taken. 18 (49%) women had a urine sent for culture; vaginal swabs were taken in 8 (22%). 4 women had symptoms of an upper respiratory tract infection with only one woman having a throat swab and sputum sent for culture.
Conclusion Our findings revealed poor compliance with Trust guidelines. The need for improved awareness amongst our maternity staff has been addressed by including training in the early recognition and management of pregnancy-related sepsis in the mandatory Skills Drills sessions.
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