Published: 19 December 2024
Summary
The need for such a guideline was originally identified by the 2007 Confidential Enquiry into Maternal Deaths. The scope of this guideline covers the recognition and management of sepsis in the antenatal, intrapartum and postpartum periods, including post-abortion sepsis. The scope includes bacterial infections arising in the genital tract or elsewhere and influenza and their management in secondary care. Sepsis arising due to primary viral (other than influenza and HSV) or parasitic infection is outside the scope of this guideline. There is separate specific guidance available on Coronavirus (COVID-19) infection in pregnancy.
Sepsis during and following pregnancy remains an important cause of maternal death globally, accounting for 11% of all maternal deaths. Between 2019–21, 241 of 2 066 997 women giving birth in the UK died. Of these, 78 women died of sepsis, either direct or indirect. Despite a statistically non-significant increase in the overall maternal death rate due to sepsis in the UK between 2016–18 and 2019–21, most of this was accounted for by SARS-COV-2 viral infections in unvaccinated women.
Suboptimal care continues to be identified in many cases where women and people die from sepsis. To reduce maternal death from sepsis requires high levels of vigilance and to “Think Sepsis” at an early stage with any unwell, pregnant or recently pregnant woman or person. Key actions are the importance of early diagnosis, the rapid initiation of broad spectrum antibiotics and the need for review by senior doctors and midwives and early involvement of relevant experts such as infection specialists and critical care, where appropriate. To avoid preventable deaths the importance of maternal vaccination for influenza and COVID-19 must be continually promoted.
This guideline replaces the 2012 Green-top Guidelines No. 64a Bacterial Sepsis in Pregnancy and No. 64b Bacterial Sepsis following Pregnancy.
COVID disclaimer
This guideline was developed as part of the regular programme of Green-top Guidelines, as outlined in our Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.
Version history
This is the second edition of this guideline.
The review process will commence in 2027 unless otherwise indicated.
Developer declaration of interests
Declarations of interest are stated within the guideline document.