what is puerperal?
the 6 weeks after child birth when the women's reproductive organs return to their non pregnant state
what is antepartum?
occurring not long before childbirth
what types of sepsis are one of the leading causes of maternal mortality in the uk?
how can it be related?
- directly i.e. pregnancy or genital tract related
- indirectly e.g. influenza, pneumonia, E coli, group A&B strep
who should be considered for sepsis?
- any women who:
- is pregnant
- given birth or had a termination of preg or miscarriage within the past 6 weeks.
what are the high risk factors for sepsis?
- impaired immune system due to illness/ drugs
- gastational diabetes, diabetes or other comorbidities
- undergone invasive procedures e.g. C section, forceps delivery, removal of retained product of conception
- prolonged rupture of membranes
- been in close contact with people with group A strep
- have continued vaginal bleeding or offensive vaginal discharge
what are the signs and symptoms of maternal sepsis?
- history of infection
- SBP <90mmHg
- body temp <36 or >38
- cardiovascular compromise- tachycardia, prolonged cap refill
- altered mental state
- D and V
- mottled skin or rash -generalised/ purpuric (non-blanching)
- abdominal/pelvic pain
- offensive discharge or wound
- productive cough
- not passed urine in last 12-28 hours
what position should this patient be placed in?
- if reduced LOC- full lateral (recovery)
- or supine with manual uterine displacement