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Cited by 157Sepsis Diagnosis and TreatmentNeonatal and Maternal InfectionsMaternal and fetal healthcare

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

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Bonet, Mercedes, Nogueira Pileggi, Vicky, Rijken, Marcus J, Coomarasamy, Arri, Lissauer, David, Souza, João Paulo, Gülmezoglu, Ahmet Metin·2017·Reproductive Health
DOI 10.1186/s12978-017-0321-6PMC PMC5450299
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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.

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Cited by

Sorted by citations

Authors
Bonet, M., Nogueira Pileggi, V., Rijken, M. J., Coomarasamy, A., Lissauer, D., Souza, J. P., & Gülmezoglu, A. M.
Affiliations
  • World Health Organization (CH)
  • University Medical Center Utrecht (NL)
  • National Health Service (GB)
  • University of Birmingham (GB)
Corresponding author
Bonet, Mercedes
ORCID
Venue
Reproductive Health
Publisher
Springer Science and Business Media LLC
Published
2017-05-30
Volume
14
Issue
1
Pages
67-67
ISSN
1742-4755 (ISSN-L)
DOI
10.1186/s12978-017-0321-6
PMC
PMC5450299
OpenAlex
W2617799798
Cited by
157
References
1
Citations by year
2026: 11 · 2025: 16 · 2024: 23 · 2023: 16 · 2022: 17 · 2021: 24 · 2020: 17 · 2019: 23 · 2018: 8 · 2017: 2
FWCI
1.81
Type
journal article
Language
en
Update notices
correction (2018-01-08)
Open access
Licence
cc-by
Locations
  • Reproductive Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
Funders
  • UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research
  • Utrecht University Medical Centre
  • University of Birmingham
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Keywords
maternal sepsis, sepsis definitions, organ dysfunction, postpartum infection, post-abortion infection, maternal infection, maternal morbidity, antimicrobial therapy, fluid resuscitation
MeSH terms
Consensus Statements as Topic, Female, Humans, Pregnancy, Pregnancy Complications, Infectious, Referral and Consultation, Prevalence, Sepsis

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