Sepsis and Septic Shock in the Peripartum Period

Maternal sepsis is a life-threatening condition that can develop during pregnancy, delivery, or the postpartum period. It is one of the most significant causes of maternal mortality worldwide and is the third most common cause of maternal death, accounting for 10.7% of all maternal deaths. It is characterized by an abnormal inflammatory response to a pathogen that can result in the excessive release of cytokines and mediators leading to many pathophysiological changes that ultimately cause septic shock. Early identification and treatment of sepsis are essential to prevent maternal and fetal morbidity and mortality. The initial management involves rapid activation of a sepsis rapid response team, stabilization of the patient, and history-taking and physical examination. Laboratory investigations aid in evaluating alternative diagnoses and identifying organ dysfunctions. Antibiotic therapy should be initiated as soon as possible and adjusted accordingly based on culture results. Common antibiotic regimens for maternal sepsis based on the suspected etiology are also discussed. This chapter provides an overview of epidemiology, etiology, pathophysiology, and the management of peripartum sepsis.