Septic miscarriage
- Sepsis is a major cause of maternal mortality in the UK.
- 10% of deaths prior to 24 weeks gestation are due to sepsis (MBRRACE-UK 2016).
- Since the 1967 Abortion Act, the death rate from sepsis following termination or miscarriage has fallen dramatically from 66 deaths in 1964–1966 to only nine early pregnancy deaths in 2012-14.
- Pregnancy-related sepsis can be overwhelming and may not be recognised immediately.
- The
CEMACH report (2000–2002) highlighted the issue that junior doctors may not seek advice of consultants in time, often because of the lack of awareness of the possibility of serious infection and its signs and symptoms. - Sepsis following surgical evacuation of the uterus may be due to perforation as well as retained products of conception.
- Non-gynaecological causes of sepsis should also be considered.
- Include the multidisciplinary team early, including an anaesthetist, microbiologist, haematologist and intensivist.