Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation

Reproductive Health

David Lissauer¹  Marcus J Rijken²  Vicky Nogueira Pileggi³  Arri Coomarasamy⁴  João Paulo Souza⁵  Mercedes Bonet⁵  Ahmet Metin Gülmezoglu⁵ 

[1] Birmingham Centre for Women’s and Children’s Health, College of Medical and Dental Sciences, University of Birmingham;Department of Obstetrics and Gynaecology and Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht University Medical Centre;Department of Social Medicine and Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo;Institute of Metabolism and Systems Research, University of Birmingham;UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization;

关键词: Sepsis;    Maternal sepsis;    Consensus;    Definition;   

DOI  :  10.1186/s12978-017-0321-6

来源: DOAJ

【 摘 要 】

Abstract Background There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis. Methods All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included. A multidisciplinary international panel of experts was surveyed through an online consultation in March-April 2016 on their opinion on the existing sepsis definitions, including new definition of sepsis proposed for the adult population (2016 Third International Consensus Definitions for Sepsis and Septic Shock) and importance of different criteria for identification of maternal sepsis. The definition was agreed using an iterative process in an expert face-to-face consensus development meeting convened by WHO and Jhpiego. Results Standardizing the definition of maternal sepsis and aligning it with the current understanding of sepsis in the adult population was considered a mandatory step to improve the assessment of the burden of maternal sepsis by the expert panel. The literature review and expert consultation resulted in a new WHO consensus definition “Maternal sepsis is a life-threatening condition defined as organ dysfunction resulting from infection during pregnancy, child-birth, post-abortion, or post-partum period”. Plans are in progress to validate the new WHO definition of maternal sepsis in a large international population. Conclusion The operationalization of the new maternal sepsis definition requires generation of a set of practical criteria to identify women with sepsis. These criteria should enable clinicians to focus on the timely initiation of actionable elements of care (administration of antimicrobials and fluids, support of vital organ functions, and referral) and improve maternal outcomes.

【 授权许可】

Unknown