During pregnancy, there are a wide variety of complications that can arise, from hypertension to gestational diabetes, and even sepsis. Although a lot of complications can be caught early, new research is showing that tests might not always catch sepsis in pregnancy. And according to researchers, it's both a cause for concern and a push to take action.
People sometimes think of sepsis as poisoning in your body, but that's not entirely accurate. Sepsis is the body's severe response to an infection. According to WebMD, it occurs when the body sends chemicals into your bloodstream to fight something off, but what actually ends up happening is that those chemicals trigger inflammation throughout the body. This can damage multiple organ systems, cause blood pressure to drop, and possibly lead to death.
In the United States, maternal sepsis, or sepsis that occurs during pregnancy, caused 12.8 percent of pregnancy related deaths between 2011 and 2014, according to the Centers for Disease Control and Prevention. Of the top ten causes of pregnancy related deaths listed, maternal sepsis ranked third.
Maternal sepsis is very preventable, according to the World Health Organization. To do so, however, requires early detection, a correct diagnosis, and treatment, as outlined by Sepsis Alliance. Early intervention is key.
Now, new research is showing that some of the tests that medical professionals used to rely on to detect sepsis may not catch maternal sepsis at all.
To identify an infection, you look at, as outlined by the Mayo Clinic, vital signs like blood pressure, temperature, and respiratory rate. These are all things that can be easily altered in pregnancy. For example, the CDC noted that hypertension (high blood pressure) occurs in 6 to 8 percent of all pregnancies.
For a paper published in Anesthesia & Analgesia, researchers examined medical records to see which three screening tools worked best at catching sepsis cases. According to the study's abstract, researchers evaluated the Systemic Inflammatory Response Syndrome (SIRS) criteria; the Sequential Organ Failure Assessment (qSOFA); and the Maternal Early Warning (MEW) criteria.
They found that the three screening tools all had very different sensitivities and specificities. Sensitivity is the ability to identify patients with a particular condition, while specificity is the ability to identify patients without a particular condition, as outlined by Eurek!Alert.
Researchers found that the SIRS tool had the highest sensitivity, but the lowest specificity; qSOFA had the lowest sensitivity and highest specificity, missing about half of sepsis patients, according to EurekaAlert!.
There are no good ways to identify maternal sepsis in women early. Melissa Bauer, a member of the study, urged doctors to closely monitor their patients.
"Every women who died hadn't had their vital signs checked in quite a while," Bauer said, according to Eurek!Alert, "We need physicians to take a good, long look at the patient and make sure that vital signs are reassessed frequently, because things can change quickly."
Maternal sepsis can be treatable, if caught, and it's clear that better systems need to be developed. For now, the study argued that healthcare professionals need to take action.
Season 2 of Doula Diaries shares the stories of fearless doulas helping their clients take control of their births and make tough choices that feel right to them. Watch the first episode of the new season Monday, November 26th.