Saving Mothers' Lives: - Public Health Agency for Northern Ireland

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Multidisciplinary care, staffi ng and facilities
Consultants should be involved in the patient’s care as early as possible. A multidisciplinary team approach
is required including haematologists, microbiologists, anaesthetists and intensive care specialists. Critically
ill patients should be cared for in a critical care or high dependency unit with adequate staff and facilities.
Conclusion
In the past, puerperal sepsis or ‘childbed fever’ was a leading cause of maternal death and its signs and
symptoms were widely known. Antisepsis, antibiotics and changing practice over the years mean that
genital tract sepsis has become much less common and death is rare. The fear and respect with which it
was held in the past by obstetricians, midwives and patients has disappeared from our collective memory.
Action is now required to raise awareness of the signs and symptoms of sepsis and recognition of critical
illness among staff in maternity units or in the community, Emergency Departments, and among GPs and
health visitors.
The cases in this Report clearly demonstrate that genital tract sepsis is still a problem, that is repeatedly
missed and there is often failure to treat women early and aggressively enough. Some of these maternal
deaths may have been prevented if the signs and symptoms of sepsis and developing septicaemic shock
had been recognised and treated earlier. Nevertheless the clinical picture of life-threatening sepsis often
develops very rapidly and in many of the cases the outcome could not have been prevented.
References
1 Mylonakis E, Paliou M, Hohmann EL, Calderwood SB, Wing EJ. Listeriosis during pregnancy. A Case
Series and Review of 222 Cases. Medicine 2002: 81(4); 260-269.