Maternal sepsis remains one of the main causes of maternal morbidity and mortality. According to reports, direct obstetric infections are the third most common cause of maternal mortality, accounting for 10.7% of all maternal deaths in low-and middle-income countries and 4.7% in high-income nations. The assessment of maternal sepsis is extremely difficult due to the physiological changes and the variety of sepsis criteria. Early indications of sepsis can be difficult to detect due to typical physiological changes throughout pregnancy and maternal efforts during labor. The symptoms of sepsis such as tachycardia, tachypnea, and leukophilia are, as well, typical physiological changes that occur throughout pregnancy and childbirth. The vaginal, urinary, and respiratory tracts are frequently the sites of infection that can potentially lead to sepsis during pregnancy. Endometritis is the most typical postpartum infection linked to sepsis. In addition to the pregnancy itself, pregnant and puerperal women may be at risk for sepsis for additional reasons. In the obstetric population, sepsis clinical characteristics can differ and may also depend on the infection’s origin. A variety of diagnostic scoring systems and methods have been offered to address the challenges in the diagnosis of sepsis in the obstetric population. These scoring systems were created to help clinicians quickly assess the severity of each patient’s condition and initiate interventions, thereby lowering morbidity and death. Specific to maternity settings are MEOWS (Modified Early Obstetric Warning System) and SOS (Sepsis in Obstetrics Score). Obstetric sepsis is managed by resuscitating and stabilizing the patient, halting further deterioration, and enhancing tissue perfusion to limit or avoid organ damage.
According to the widely accepted SSC (Surviving Sepsis Campaign) Guideline, the SSC Hour-1 bundle, which consists of several interventions, should be started within 1 h of the diagnosis of sepsis. Broad-spectrum antibiotics must be chosen to cover a variety of frequently implicated pathogens, including both gram-negative and gram-positive microorganisms and anaerobes, for initial therapy. A change toward a personalized care approach is consequently being developed and utilized more frequently as a result of new technologies and growing evidence.