INFECTIOUS DISEASES AND MATERNAL SEPSIS

There are many bacterial, viral, and protozoal infections significantly affect maternal and fetal health. Accurate diagnosis, effective treatment, and preventive measures are crucial for ensuring optimal out-comes. According to the World Health Organization (WHO), maternal sepsis is defined as a life-threat-ening condition that arises during pregnancy, childbirth, abortion, or the postpartum period as a result of infection and progresses to organ dysfunction. It ranks as the third leading cause of maternal mor-tality worldwide, following hemorrhage and hypertensive disorders. Pregnancy-related physiological, immunological, and mechanical changes increase women’s susceptibility to infections. Risk factors for maternal sepsis may be categorized as obstetric (e.g., chorioamnionitis, septic abortion), non-obstetric (e.g., urinary tract infections, malaria, TORCH infections), and hospital-acquired. Clinical presenta-tions range from asymptomatic cases or mild influenza-like symptoms to severe complications such as sepsis, intensive care unit (ICU) admission, and death. Due to the more severe course of infections during pregnancy compared to the general population, careful monitoring and timely intervention are imperative. Current guidelines should be reassessed and adapted to the physiological changes of pregnancy, establishing modified diagnostic and management criteria. Scoring systems such as the Sequential Organ Failure Assessment (SOFA) can provide guidance for monitoring clinical progres-sion. Preventive measures implemented before the disease becomes clinically evident are as important as therapeutic interventions. Early warning parameters for maternal sepsis and septic shock include heart rate, blood pressure, respiratory rate, oxygen saturation, maternal agitation, and altered mental status. Among these, mental status changes, systolic blood pressure, and respiratory rate are particu-larly valuable for rapid clinical decision-making. Prompt assessment and, when necessary, immediate referral to advanced care facilities are essential. Following diagnosis, management should occur in a fully equipped healthcare setting under the care of experienced professionals. Treatment should begin promptly with broad-spectrum antibiotics due to the potential for rapid clinical deterioration, with subsequent adjustments guided by blood culture results. Intravenous fluid resuscitation should be ini-tiated to ensure adequate tissue perfusion, and vasopressor agents considered in cases of persistent hypotension. Lactate monitoring is an essential indicator of tissue perfusion, aiding in the evaluation of treatment efficacy and clinical progression. Through well-structured monitoring and timely inter-vention, maternal sepsis can be effectively managed, reducing its contribution to preventable maternal mortality.