Sepsis and Pregnancy: Recognising Symptoms, Causes, and Prevention

Sepsis is a serious medical condition that can be life-threatening, especially during pregnancy. As the body adapts to pregnancy, it becomes more susceptible to infections. While infections are relatively common, sepsis during pregnancy is a rare but severe complication that requires immediate attention. In this article, we will explore the causes, symptoms, and risks of sepsis during pregnancy, as well as how to recognise it and what measures can be taken to prevent it. Understanding the signs of sepsis and the importance of timely intervention is crucial for both the health of the mother and the developing baby. This article will focus on the role of antenatal care in identifying and managing sepsis and the steps expectant mothers can take to reduce their risk. We will also cover the significance of early diagnosis, treatment, and ongoing support during pregnancy to maintain maternal and fetal health.

What is Sepsis?

Sepsis occurs when the body’s response to an infection becomes dysregulated and triggers widespread inflammation. This inflammation can lead to organ damage and failure if left untreated. During pregnancy, a woman’s immune system is altered to protect both her and the growing fetus. While this natural adjustment helps prevent the body from rejecting the baby, it can also make pregnant women more susceptible to infections, which can result in sepsis. Infections that lead to sepsis during pregnancy can originate from various sources, including the urinary tract, genital tract, or other parts of the body. Antenatal care plays an essential role in identifying and managing infections early to prevent the escalation of sepsis.

Causes of Sepsis During Pregnancy

The most common cause of sepsis in pregnancy is an infection. While any infection can potentially lead to sepsis, some infections are more likely to cause complications. These include:

• Urinary Tract Infections (UTIs): UTIs are common in pregnancy due to hormonal changes that affect the urinary tract. If left untreated, a UTI can spread to the kidneys and result in sepsis.
• Infections of the Genital Tract: Infections such as bacterial vaginosis or sexually transmitted infections (STIs) can lead to sepsis if they spread to the uterus or other reproductive organs.
• Pneumonia: Respiratory infections can also trigger sepsis. Pregnant women may be more vulnerable to respiratory infections due to changes in the immune system and lung function.
• Infections Post-Surgery or Postpartum: Women who have had a caesarean section or other surgical interventions during pregnancy may be at increased risk of developing an infection that leads to sepsis.
• Chorioamnionitis: This is an infection of the amniotic sac that surrounds the baby and is one of the more serious causes of sepsis during pregnancy. It typically occurs when bacteria enter the uterus, leading to inflammation and infection. It’s important for expectant mothers to receive regular antenatal checkups to screen for and treat infections that could lead to complications like sepsis.

Symptoms of Sepsis During Pregnancy

Recognising the symptoms of sepsis during pregnancy is essential for prompt treatment. The symptoms of sepsis can develop rapidly and may initially resemble flu-like signs. However, sepsis requires immediate medical attention, as it can quickly progress to life-threatening complications. Symptoms may include:

• Fever and chills: A high fever is a common sign of infection, and chills may accompany it.
• Rapid breathing or shortness of breath: Sepsis can affect lung function, making it harder to breathe.
• Increased heart rate: The body tries to compensate for the infection by increasing the heart rate.
• Low blood pressure: As sepsis progresses, blood pressure can drop, leading to dizziness or fainting.
• Confusion or disorientation: Sepsis can affect mental clarity, leading to confusion or a sense of disorientation.
• Severe pain or discomfort: Pain in the abdomen, back, or other areas may indicate an infection.
• Swelling: Fluid retention and swelling, particularly in the hands and feet, may occur due to a drop in blood pressure. Pregnant women who experience any of these symptoms should seek medical help immediately. Timely intervention and early diagnosis are crucial for preventing complications such as organ failure and fetal distress.

How Antenatal Care Helps Prevent Sepsis

Antenatal care is vital for monitoring both the mother and the baby throughout pregnancy. During regular antenatal appointments, healthcare providers can identify early signs of infection and address them promptly to prevent the onset of sepsis. Key aspects of antenatal care that can help prevent sepsis include:

Regular Screening for Infections

As part of pregnancy care, expectant mothers are routinely screened for conditions that may increase their risk of infection, such as UTIs, STIs, and group B streptococcus (GBS). Early detection of these infections allows for appropriate treatment before they progress into sepsis.

Monitoring and Managing UTIs

Pregnant women are particularly prone to UTIs due to changes in the urinary tract. Prenatal care includes testing for UTIs and providing treatment with antibiotics when necessary. Prompt treatment of UTIs is crucial in preventing them from spreading to the kidneys or bloodstream, potentially leading to sepsis.

Managing Infections of the Genital Tract

Infections such as bacterial vaginosis and STIs can increase the risk of sepsis during pregnancy. Regular screening for STIs and appropriate treatment during antenatal appointments can significantly reduce the likelihood of infection spreading.

Post-Surgical Care and Monitoring

For women who undergo caesarean sections or other surgical procedures during pregnancy, proper aftercare is essential to reduce the risk of infection. Antenatal support includes educating women on signs of infection after surgery and ensuring proper wound care to minimise complications.

Treatment of Sepsis During Pregnancy

Sepsis is a medical emergency that requires immediate treatment. Treatment typically involves the following:

Hospitalisation

Most pregnant women with sepsis will require hospitalisation to receive intravenous (IV) antibiotics and fluids. Close monitoring is essential to assess the progression of the condition and to support the body’s response to infection.

Antibiotics

Early and broad-spectrum antibiotics are typically administered to treat the underlying infection causing sepsis. The choice of antibiotics may be adjusted based on the results of culture tests.

Organ Support

In severe cases, sepsis can lead to organ failure. Supportive care, including oxygen therapy, dialysis, or mechanical ventilation, may be required to help the body recover from organ dysfunction.

Delivery of the Baby

If the infection is affecting the fetus or if there are signs of fetal distress, doctors may recommend early delivery to protect both mother and baby. In some cases, a caesarean section may be necessary, especially if there are concerns about infection affecting the birth canal.

Prevention of Sepsis During Pregnancy

While sepsis cannot always be prevented, there are several measures that expectant mothers can take to reduce their risk:

• Practice good hygiene: Regular handwashing, especially after using the bathroom or handling food, is crucial for preventing infections.
• Attend all antenatal appointments: Regular antenatal checkups help identify potential issues early, reducing the risk of complications like sepsis.
• Take prenatal vitamins: Maintaining overall health through proper nutrition and taking antenatal vitamins ensures that the immune system is functioning well and can fight off infections.
• Stay hydrated and rest: Proper hydration and rest are important for supporting a healthy pregnancy and preventing infections.
• Seek medical advice if you suspect an infection: If you notice any symptoms of infection, such as fever, pain, or unusual discharge, contact your antenatal clinic for advice and treatment.

Can Sepsis Kill My Baby?

Yes, sepsis can be extremely dangerous for both the mother and the baby during pregnancy. If left untreated, sepsis can lead to serious complications, including organ failure, and in severe cases, it can be fatal for both the mother and the fetus. During pregnancy, the immune system undergoes changes, which makes the mother more vulnerable to infections. When an infection triggers sepsis, it can affect the body’s ability to circulate blood effectively, leading to a drop in blood pressure, organ dysfunction, and reduced oxygen supply to vital organs, including the placenta. If sepsis is caused by an infection in the reproductive organs, such as chorioamnionitis (infection of the amniotic sac), it can directly impact the baby, leading to complications such as:

1. Preterm labour: Sepsis may trigger early contractions, leading to premature birth.
2. Fetal distress: Lack of oxygen and nutrients due to compromised blood flow can lead to fetal distress, affecting the baby’s heart rate and overall well-being.
3. Stillbirth: In severe cases, if sepsis causes significant damage to the placenta or leads to widespread organ failure in the mother, it can result in stillbirth.
4. Infections transmitted to the baby: In some cases, infections causing sepsis may be passed on to the baby during delivery, leading to neonatal infections that can be life-threatening. Because of these potential risks, it’s essential to recognise the symptoms of sepsis early and seek immediate medical care if you suspect that you or your baby may be at risk. Prompt intervention with antibiotics and supportive care can significantly improve the chances of a healthy outcome for both mother and baby. Regular antenatal care plays a critical role in detecting and treating infections early, preventing the escalation to sepsis. If you have concerns or experience symptoms like fever, chills, severe pain, or confusion, reach out to your healthcare provider as soon as possible. Early diagnosis and treatment are essential to preventing serious complications and safeguarding both maternal and fetal health. Sepsis during pregnancy is a rare but serious complication that can have severe consequences for both the mother and the baby. By attending regular antenatal appointments and seeking prompt treatment for infections, women can reduce their risk of developing sepsis. Being aware of the symptoms of sepsis and knowing when to seek medical help is essential for ensuring a healthy pregnancy and a safe delivery. Proper antenatal care, including regular screenings, appropriate treatments for infections, and antenatal support, plays a crucial role in reducing the risk of sepsis and maintaining overall maternal and fetal health. By staying informed and proactive, expectant mothers can ensure a safer, healthier pregnancy journey.