Sepsis is our number one quality priority: Day 23 of our campaign

November 23, 2018

Sepsis in Maternity

Sepsis is a rare but important cause of maternal deaths every year in the UK. Thanks to the longest running clinical audit in medicine (Enquiry into Maternal Deaths Triennial Report) which dates back to the 1950s we know the direct and indirect causes of why mothers die in pregnancy and up to a year after giving birth. World-wide sepsis remains a leading cause but in the UK it has dropped down the list so that in 2014-16 genital tract or puerperal sepsis accounted for 11 maternal deaths (4% of total). This is still 11 mothers too many especially given our knowledge that:

• Prompt recognition of signs of sepsis
• Use of warning scores/charts and pathways for management (“Sepsis 6”)
• Effective treatment, including IV antibiotics, starting within one hour

All of which can all make a difference in preventing unnecessary serious harm or even death.

In maternity at SWBH we use specialised MEWS charts to pick up amber and red flag signs for sepsis and a maternity-modified Sepsis 6 pathway. This was designed in conjunction with microbiology and has then been promoted and adopted across the West Midlands in other maternity units. It is designed to pick up those women antenatally, in labour or following delivery who do develop genuine signs of sepsis and who require urgent medical and midwifery intervention whilst avoiding labelling lots of women who can develop minor signs as a normal consequence of pregnancy or labour. This has helped us to target treatment more effectively, avoid unnecessary antibiotic usage, reduce maternity HDU occupancy whilst still reducing maternal (and neonatal) harm from maternal sepsis.

This is down to good staff knowledge, effective team working across maternity and THINKING SEPSIS.