Sepsis in Pregnancy
Maternal sepsis is a life-threatening medical emergency defined as organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion, miscarriage, or the postpartum period. In the United States, sepsis or infection is the second leading cause of pregnancy-related deaths. Healthcare providers need to know the signs and symptoms of maternal sepsis, as well as how to screen for sepsis early and initiate treatment. This training module describes the unique physiology during and following pregnancy and challenges to identifying and managing maternal sepsis. Strategies to recognize and treat maternal sepsis in the emergency department, floor, critical care, and obstetrical units will be presented. The personal experience of a maternal sepsis survivor will be shared. To prevent infections that can lead to sepsis, it is critical to provide medical care immediately. Fast recognition and treatment of sepsis is key to increasing mothers' chances of survival.
Emergency room physicians, family practice physicians, obstetricians, internal medicine physicians, intensivists, hospitalists, anesthesiologists, nurse anesthetists, emergency room nurses, floor nurses, critical care nurses, obstetric nurses, midwives, doulas, and all healthcare staff that provide care to women from conception through the postpartum period.
At the end of the training module, the learner should be able to:
- Discuss the national and global issue of mortality and morbidity surrounding maternal sepsis;
- Define maternal sepsis;
- Describe physiologic changes during pregnancy as it relates to sepsis;
- Explain key challenges related to identification and treatment of maternal sepsis;
- Identify the risk factors for maternal sepsis;
- Restate treatment recommendations for maternal sepsis;
- List screening and protocols specific to maternal sepsis;
- Describe the algorithm for a perinatal screening program.
Sepsis Alliance gratefully acknowledges the support and subject matter expertise provided for this training module by ACOG District II.
Maternal Sepsis Survivor
Megan Snair, MPH, has more than ten years of experience working as a science writer, program director, and public health subject matter expert. She led multiple landmark activities and scientific publications as a senior program officer and study director at the National Academies of Sciences, Engineering, and Medicine covering topics of health policy, infectious disease outbreaks, health system resilience, and social determinants of health. However, despite this experience, Megan was blindsided in 2019 when she contracted a Group A strep infection and became septic after the delivery of her son. She spent a week in the hospital, including time in the ICU, while doctors worked to figure out what was causing her condition and then spent many weeks recovering at home. Because she was so unaware of the signs and symptoms of sepsis, she is committed to helping educate others - especially on the dangers of maternal sepsis - so that both patients and healthcare providers understand sepsis can happen to anyone, and are empowered to make a fast and accurate diagnosis.
Ashlesha Dayal, MD
Vice Chair Obstetrics, NewYork-Presbyterian/Queens
Dr. Ashlesha K. Dayal is a Maternal Fetal Medicine specialist, Vice Chair of Obstetrics at NewYork-Presbyterian/Queens, in Flushing NY, and an Associate Professor of Clinical Obstetrics and Gynecology at Weill Cornell Medical College. She focuses her clinical efforts on maternal safety, patient safety, and decreasing perinatal morbidity, particularly in the labor and delivery setting. Dr. Dayal has been on the Preterm Birth Task Force, the 17P Committee and serves as the Chair of Section 3 of District II of ACOG. She is also the residency site director for the Weill Cornell ObGyn Residency Training Program for New York-Presbyterian/Queens Hospital. Dr. Dayal serves on the Sepsis Taskforce for District 2 and the Postpartum Task Force for the District. Dr. Dayal received her medical degree from Boston University School of Medicine from the Six Year BA/MD Program and completed her residency at Long Island Jewish Medical Center, New Hyde Park NY. She completed her fellowship in Maternal Fetal Medicine at Albert Einstein College of Medicine, Bronx, NY.
Loralei L. Thornburg, MD
Professor, Department of Obstetrics and Gynecology, University of Rochester Medical Center
Loralei Thornburg is a professor of Obstetrics and Gynecology at the University of Rochester, where she did both Obstetrics and Gynecology residency and Maternal-Fetal Medicine fellowship. She now serves as both the division and fellowship director. A native of western Michigan, she went to medical school at Wayne State in Detroit. She teaches annually at the SMFM/Banner Obstetrical Critical Care course, including both lecture and simulation- which focus on optimizing care for pregnant patient with critical illness and events. She has the only neurology in pregnancy book that includes a multidisciplinary authorship across the broad range of specialists needed to care for neurologic disease in pregnancy. She lives with her husband, an internist, as well as 2 children, a leopard gecko, and a rabbit.
Sandra Asanjarani, RNC-OB, MS, NPWH, C-EFM
Perinatal Safety Officer, NewYork-Presbyterian/Queens
Sandra Asanjarani is the perinatal safety nurse and the team leader for the Baby-Friendly Journey at NewYork-Presbyterian/Queens. She obtained her RN degree from Queensborough Community College and her Bachelor in Science degree from Adelphi University. Sandra continued her studies and obtained her Nurse Practitioner credential in Women’s Health and Obstetrics and Gynecology as well as her Perinatal Clinical Specialty Degree at Stony Brook University. Sandra holds multiple certifications in her field of expertise. Prior to working at NewYork-Presbyterian/Queens, she worked as an Associate Director for Quality/Safety and Risk Management at Jacobi Medical Center. She has worked in the field of maternal child as an administrator, labor and delivery nurse manager, perinatal informatics specialist, and a labor and delivery nurse for over 25 years in both the private sector and public sector. Sandra is a member of the executive board of directors at the New York State Nurses Association and is on the March of Dimes board of directors for Queens. She recently published a chapter in a medical textbook with Dr. Daniel Skupski about Hypertensive Crisis in Pregnancy. She has received many awards for her expertise and knowledge. Her most recent award was in 2019 for Advance Practice Nurse at NewYork-Presbyterian/Queens Hospital.
In accordance with policy, all faculty and planning committee members have signed a conflict of interest statement in which they have disclosed any financial interests or other relationships with industry relative to topics they will discuss at this program. At the beginning of the program, faculty members are expected to disclose any such information to participants. Such disclosure allows you to evaluate better the objectivity of the information presented in lectures. All individuals in control of content disclosed no relevant financial interests.
The American College of Obstetricians and Gynecologists is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American College of Obstetricians and Gynecologists designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Provider approved by the California Board of Registered Nursing, Provider Number CEP17068 for 2.5 contact hours.
Other healthcare providers will receive a certificate of attendance for 2.0 contact hours.
The information on or available through this site is intended for educational purposes only. Sepsis Alliance does not represent or guarantee that information on or available through this site is applicable to any specific patient’s care or treatment. The educational content on or available through this site does not constitute medical advice from a physician and is not to be used as a substitute for treatment or advice from a practicing physician or other healthcare provider. Sepsis Alliance recommends users consult their physician or healthcare provider regarding any questions about whether the information on or available through this site might apply to their individual treatment or care.
ALL FACULTY/PLANNING COMMITTEE/REVIEWERS/STAFF HAVE NO DISCLOSURES TO DECLARE.
- 1.00 AMA PRA Category 1 Credit™This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Children’s Hospital Alliance and the Sepsis Alliance. The Children’s Hospital Alliance is accredited by the ACCME to provide continuing medical education for physicians.
- 2.00 Participation
- 2.50 RN CE Contact HoursProvider approved by the California Board of Registered Nursing, Provider Number CEP17068.