Title: Clinico-microbiological pattern and pregnancy outcome in women with obstetric sepsis from a low middle income country
Background: Sepsis during pregnancy is a global problem and an important cause of pregnancy related adverse maternal and perinatal outcome including mortality. Various scores have been described to identify risk of adverse maternal outcome.
Methods: This was a prospective study from a tertiary care center located in Southern India done between May 2022 and November 2023. Sepsis was defined using OmqSOFA (Obstetrically modified quick sequential organ failure assessment score) in women presented with infection and abnormal SIRS criteria. Clinical factors, microbiological pattern and antibiotic sensitivity were described. Also, usefulness of various organ specific scores in the assessment of adverse maternal outcome was studied.
Results: The incidence of sepsis was 6.8/1000 deliveries during the study period. Anemia, caesarean section and postpartum hemorrhage were the most common risk factors. Majority of the infections happened in the postpartum period. Endometritis, respiratory tract followed by surgical site were the common sites for infections. Though E. coli was the most common organism found, 40% were polymicrobial. The rate of ICU stay was almost ~80% and the fatality rate was 13%. The SOS (Sepsis in obstetric score) and OmSOFA had moderate discriminatory zone for the adverse maternal outcome.
Conclusion: E. coli was the most common organism for obstetric sepsis, and almost half of them had adverse maternal outcome. OmSOFA and SOS performed better for the adverse maternal outcome with sepsis.