Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
Division of Maternal-Fetal Medicine, Baptist Health Lexington, Lexington, Kentucky.
Am J Perinatol. 2023 May;40(7):718-730. doi: 10.1055/s-0041-1736382. Epub 2021 Oct 11.
Sepsis is a life-threatening syndrome caused by the body's response to infection. The Global Maternal Sepsis Study (GLOSS) suggests sepsis plays a larger role in maternal morbidity and mortality than previously thought. We therefore sought to compare national and international guidelines for maternal sepsis to determine their consistency with each other and the Third International Consensus for Sepsis and Septic Shock (SEPSIS-3). Using Cochrane Database of Systematic Reviews, PubMed, Google Scholar, and organization Web sites, we identified seven guidelines on maternal sepsis in the English language-The American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine, Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Society of Obstetric Medicine of Australia and New Zealand, Royal College of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland Institute of Obstetricians and Gynaecologists, and World Health Organization. Guidelines were reviewed to ascertain the commonality and variation, if any, in definitions of maternal sepsis, tools and criteria utilized for diagnosis, obstetric warning systems used, as well as evaluation and management of maternal sepsis. These variables were also compared with SEPSIS-3. All guidelines provided definitions consistent with a version of the SEPSIS, although the specific version utilized were varied. Clinical variables and tools employed for diagnosis of maternal sepsis were also varied. Evaluation and management of maternal sepsis and septic shock were similar. In conclusion, national and international maternal sepsis guidelines were incongruent with each other and SEPSIS-3 in diagnostic criteria and tools but similar in evaluation and management recommendations. KEY POINTS: · Definitions for maternal sepsis and septic shock are varied.. · Maternal sepsis guidelines differ in proposed criteria and tools.. · Maternal sepsis guidelines have similar management recommendations..
败血症是一种危及生命的综合征，由身体对感染的反应引起。全球产妇败血症研究（GLOSS）表明，败血症在产妇发病率和死亡率方面的作用比之前认为的更大。因此，我们试图比较产妇败血症的国家和国际指南，以确定它们彼此之间以及与第三次国际败血症和脓毒症共识（SEPSIS-3）的一致性。我们使用 Cochrane 系统评价数据库、PubMed、Google Scholar 和组织网站，确定了七种关于产妇败血症的英文指南——美国妇产科医师学会、母胎医学学会、澳大利亚和新西兰皇家妇产科医师学院、澳大利亚和新西兰产科医学学会、皇家妇产科医师学院、爱尔兰皇家内科医师学院妇产科医师学会和世界卫生组织。审查了这些指南，以确定在败血症的定义、用于诊断的工具和标准、使用的产科预警系统以及败血症的评估和管理方面是否存在共同点和差异。这些变量也与 SEPSIS-3 进行了比较。所有指南都提供了与 SEPSIS 版本一致的定义，尽管使用的具体版本有所不同。用于诊断产妇败血症的临床变量和工具也有所不同。产妇败血症和脓毒性休克的评估和管理相似。总之，国家和国际产妇败血症指南在诊断标准和工具方面与彼此和 SEPSIS-3 不一致，但在评估和管理建议方面相似。要点：
败血症和脓毒性休克的定义各不相同。
产妇败血症指南在提出的标准和工具方面存在差异。
产妇败血症指南的管理建议相似。
