March 6, 2023

In the literature...

Risk Factors, Trends, and Outcomes Associated With Postpartum Sepsis Readmissions

Obstetrics & Gynecology March 2024 , Volume 143 ( 3 ), p 346 – 354

OBJECTIVE:

To evaluate the prevalence, timing, clinical risk factors, and adverse outcomes associated with postpartum readmissions for maternal sepsis.

RESULTS:

Overall, 15,268,190 delivery hospitalizations and 256,216 associated 60-day readmissions were included after population weighting, of which 16,399 (1.1/1,000 delivery hospitalizations) had an associated diagnosis of sepsis at delivery, and 20,130 (1.3/1,000 delivery hospitalizations) had an associated diagnosis of sepsis with postpartum readmission. A sepsis diagnosis was present in 7.9% of all postpartum readmissions. Characteristics associated with postpartum sepsis readmission included younger age at delivery, Medicaid insurance, lowest median ZIP code income quartile, and chronic medical conditions such as obesity, pregestational diabetes, and chronic hypertension. Postpartum sepsis readmissions were associated with infection during the delivery hospitalization, including intra-amniotic infection or endometritis, wound infection, and delivery sepsis. Sepsis diagnoses were associated with 24.4% of maternal deaths at delivery and 38.4% postpartum, 2.2% cases of nontransfusion severe morbidity excluding sepsis at delivery and 13.6% postpartum, 15.6% of critical care composite diagnoses at delivery and 30.1% postpartum, and 11.1% of acute renal failure diagnoses at delivery and 36.4% postpartum.

CONCLUSION:

Sepsis accounts for a significant proportion of postpartum readmissions and is a major contributor to adverse outcomes during delivery hospitalizations and postpartum readmissions.

Learning Session 2 - May 6, 2024, McKimmon Center, Raleigh, NC 

Make sure your team is registered!

Malavika Prabhu, who will speak on Recognition of OB Sepsis. 

Dr Prabhu is a board-certified maternal-fetal medicine (MFM) specialist and attending physician at Massachusetts General Hospital who cares for pregnant patients and families with the full spectrum of complex pregnancies.

To complement her clinical interests, Dr. Prabhu is also a clinical researcher, with her academic interests focused on understanding how to decrease pregnancy-associated complications, as well as quality improvement work on optimizing the practice and delivery of obstetric care. She also serves as an Editorial Board member for Obstetrics & Gynecology, a leading journal in the field, as well as a member on the Publications Committee for the Society of Maternal-Fetal Medicine.

Luis Pacheco, who will speak on Treatment of Obstetric Sepsis 

Dr. Luis Pacheco is the Division Chief of Obstetrics and Maternal Fetal Medicine as well as Professor in the Department of Obstetrics and Gynecology and the Department of Anesthesiology, Division of Surgical Critical Care at the University of Texas Medical Branch in Galveston.



Dr. Pacheco’s work in both maternal fetal medicine and critical care medicine is unique in that he is the only maternal-fetal medicine specialist in the country who actually staffs a non-obstetrical surgical critical care unit along with other critical care specialists. His publications have contributed significantly to the education of maternal fetal medicine doctors and general obstetricians regarding medical complications during pregnancy. His research interest is in critical care obstetrics.

In addition -

Dr. Jim deVente will be leading a live OB Sepsis Simulation Drill and preparing you to do your own drills at your facility. Come with questions and be prepared to participate!

Melissa Bauer will again be on hand to answer your questions and help you work through issues you may have encountered and plan next steps.

Bauer, Pacheco, and Prabhu are co-authors of the Alliance for Innovation on Maternal Health Consensus Bundle on Sepsis in Obstetric Care

It is important to bring as many team members as possible. The day has been designed to give teams the opportunity to learn from the expertise of our guest speakers, participate in a sepsis simulation, and apply what you have learned to the development of your team’s ongoing PDSA cycles. A team will be required to get the most out of the day and to fully participate in the day’s activities.