Global Sepsis

Global Sepsis

The leading causes of maternal mortality and morbidity worldwide include postpartum hemorrhage (PPH), hypertensive disorders of pregnancy and sepsis.

There have been many initiatives directed at saving lives from PPH, specifically availability of low cost uterotonic drugs (i.e., misoprostol).  Similarly, prevention of eclampsia has centered around initiatives for early diagnosis, initial treatment and early referral to higher levels of care.

We understand the etiology of PPH (generally a non-involuted uterus) and are beginning to make head roads into the pathophysiology of pre-eclampsic/eclampsia.

Addressing the causes and effective treatment of maternal sepsis has been more challenging.  In the U.S. and Europe maternal sepsis has been linked to pyelonephritis, vaginal and cervical infections and increasing rates of both obesity and caesarean sections. 

Less is known about the underlying causes of sepsis in the developing world.  The condition is often under-reported with most fatalities occurring away from a healthcare facility.  Additionally, a large percentage of maternal sepsis is linked to unsafe abortion and co-existing maternal conditions (HIV-AIDS, Malaria, TB) which place a pregnant/postpartum woman at a much greater degree of risk.  A new algorithm for prevention and community based screening will be presented.