Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2014
ReviewFetal optimization during maternal sepsis: relevance and response of the obstetric anesthesiologist.
In many labor and delivery units, the obstetric anesthesiologist is often responsible for managing and stabilizing the acutely septic parturient. The management of maternal sepsis has been summarized previously; this study will focus on the implications of maternal sepsis on the fetus, and ways to optimize fetal outcomes. ⋯ In the setting of maternal sepsis, fetal optimization is frequently best accomplished by meeting maternal hemodynamic, oxygenization, and infection treatment goals. Understanding the circulatory and pathophysiologic changes that occur within the uteroplacental unit and fetus is essential to identifying and resolving potential conflicts between maternal and fetal management goals.
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The aim of the study was to provide a summary of recent guidance on sepsis in obstetrics. ⋯ Increased awareness of obstetric sepsis is required. Women and their families need to be informed about it and staff must have the skills and competencies to recognize this early. The management of severe sepsis in obstetrics is multidisciplinary. Implementation of the goals of the Surviving Sepsis Campaign into obstetric practice is important to improve outcomes. More research is needed to validate the parameters used in this and early warning scores for the obstetric population.