Abstract
Sepsis is one of the leading causes of maternal morbidity and mortality. Analyses
have determined that delays in early recognition and prompt initiation of appropriate
management are key contributing factors in maternal sepsis deaths. Recent cases of
sepsis-related maternal morbidity and mortality across Canada have highlighted the
urgent need for a national standardized approach to the detection and treatment of
maternal sepsis. The SOGC has established a national multidisciplinary maternal sepsis
task force to address this priority. The adoption of a national modified obstetric
early warning system (MEOWS) is recommended as a key first step. This early warning
scoring (EWS) system will facilitate early detection of maternal clinical deterioration
and mandate timely escalation of care appropriate for the severity of illness. There
is currently limited use of EWSs in Canada. Introducing a national EWS and a standardized
maternal sepsis management guideline provides a tremendous opportunity to improve
maternal care. A standardized approach will facilitate future evidence-based evaluation
and refinement of the tool, and enable the reduction of preventable maternal morbidity
and mortality from sepsis, as well as all causes duplicated.
Résumé
Le sepsis est l'une des principales de causes de morbidité et de mortalité maternelles.
Des analyses ont déterminé que le retard de la détection précoce et du traitement
rapide et adéquat constituent des facteurs contributifs importants des morts maternelles
dues au sepsis. De récents cas de mortalité et de morbidité maternelles liés au sepsis
partout au Canada ont mis en évidence le besoin urgent d'une démarche pancanadienne
normalisée relative à la détection et au traitement du sepsis maternel. La SOGC a
mis sur pied un groupe de travail multidisciplinaire pancanadien sur le sepsis maternel
afin de s'attaquer à cette priorité. L'adoption d'un système obstétrical national
d'avertissement précoce (Modified Early Obstetric Warning System ou MEOWS) a été recommandée
comme première étape. Ce système d'avertissement précoce (SAP) facilitera la détection
précoce de la détérioration clinique maternelle et établira une augmentation rapide
des soins appropriés à la gravité de la maladie. À l'heure actuelle, l'utilisation
du SAP est limitée. L’établissement du SAP et de directives cliniques normalisées
sur le traitement du sepsis donne une occasion remarquable pour améliorer les soins
maternels. Une démarche normalisée facilitera les futures évaluations fondées sur
les données probantes et le raffinement des outils et permettra la réduction de la
morbidité et de la mortalité maternelles évitables dues au sepsis de même que toutes
les autres causes.
Keywords
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Article info
Publication history
Published online: March 12, 2020
Footnotes
Competing Interests: The authors declare that they have no competing interests.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
