Puerperal sepsis: An integrative review
DOI:
https://doi.org/10.33448/rsd-v10i8.17374Keywords:
Sepsis; Postpartum period; Puerperal Infection.Abstract
In 2016, the concept of sepsis was redefined, however it still needs to be better characterized. In Brazil, this complication has a mortality of 28% and costs of approximately 9,100 dollars per patient. Given the difficulties of definition and diagnosis, this work aims to synthesize available scientific evidence. This is an integrative review carried out between January and June 2021, to answer “What is the recent evidence about puerperal sepsis?”. The search considered the last 5 years and resulted in 53 articles, of which 14 were selected due to the exclusion criteria. Of these, 28.6% are guidelines, 64.3% are observational studies and 7.1% are experimental. Regarding the countries of publication, more than 50% were carried out in the USA (35.75%) and England (14.3%). As for the language of the publications, 78.5% were written in English; 14.3% in Spanish, and 7.2% in Portuguese. Puerperal sepsis remains one of the main causes of morbidity and mortality worldwide. The pathophysiology is not fully understood, and scientific evidence is lacking, especially regarding early diagnosis and treatment. Regarding the diagnosis, the physiological changes of pregnancy end up masking the clinical picture and making the investigation challenging. Thus, anamnesis and physical examination are still essential, aided by complementary exams. Treatment aims at early recognition and aggressive intervention through antibiotic therapy, fluid replacement and cardiovascular support.
References
Baena, C. P. (2014). Meta-analysis and Systematic Review: Is it gold-standard? Rev Med UFPR, 1(2):71-74. https://doi.org/10.5380/rmu.v1i2.40706
Belarmino, A. C., Pinto, M. C. O., Frota, A. C., Alves, L. C., & Ferreira Júnior, A. R. (2020). Perspectivas da enfermagem sobre o protocolo da sepse materna: análise à luz da teoria da complexidade. Avances en Enfermería, 38(3), 286-295. https://doi.org/10.15446/av.enferm.v38n3.84775
Céspedes-Fernández, P. L., Díaz-Martínez, A., Vázquez-Nassiff, J. J., & Céspedes-Díaz, P. E. (2020). Factores asociados a la presentación de sepsis puerperal en provincia Guantánamo, 2017-2018. Revista Información Científica, 99(1), 12-19.
Duan, R., Xu, X., Wang, X., & Yu, H. (2019). Perinatal outcome in women with bacterial sepsis: A cross-sectional study from West China. Medicine, 98(44):e17751. https://doi.org/10.1097/MD.0000000000017751
Foeller, M. E., Sie, L., Foeller, T. M., Girsen, A. I., Carmichael, S. L., Lyell, D. J., Lee, H. C., & Gibbs, R. S. (2020). Risk factors for maternal readmission with sepsis. American journal of perinatology, 37(5), 453–460. https://doi.org/10.1055/s-0039-1696721
Galvão, A., Braga, A. C., Gonçalves, D. R., Guimarães, J. M., & Braga, J. (2016). Sepsis during pregnancy or the postpartum period. Journal of obstetrics and gynaecology, 36(6), 735–743. https://doi.org/10.3109/01443615.2016.1148679
García, C. R. A., Luna, Z. M., & Acosta, J. G. (2016). Síndrome de shock tóxico en el puerperio: Reporte de un caso. Revista de la Asociación Mexicana de Medicina Crítica y Terapia Intensiva, 30(1), 55-58.
Knight, M., Mottram, L., Gray, S., Partlett, C., Juszczak, E., & ANODE collaborative group (2018). Prophylactic antibiotics for the prevention of infection following operative vaginal delivery (ANODE): study protocol for a randomised controlled trial. The Lancet, 19(1), 395.
Koo, Y. J. (2018). Puerperal septic shock and necrotizing fasciitis caused by staphylococcus caprae and Escherichia coli. Yeungnam University journal of medicine, 35(2), 248–252. https://doi.org/10.12701/yujm.2018.35.2.248.
Lopez, J. P. & Müller, E. A. (2016). Late puerperal sepsis, case report and literature review. Rev Case Rep, 2(1): 17-26.
Matos, K. L. A., Morais, L. O., Cavalcante, C. C., Nunes, E. J. G., Pereira, T. Z., Silva, L. P., Potros, F. R., Maia, P. R., Ribeiro, F. M. (2019). Sepse durante o período gestacional. Revista Eletrônica Acervo Saúde, 11(17): e1166. https://doi.org/10.25248/reas.e1166.2019
Mendes, S., Silveira, P., & Galvão, M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm.,17(4): 758-64. https://doi.org/10.1590/S0104-07072008000400018
Morgan, M. (2020). Challenging infections in pregnancy. Obstetrics, gynaecology and reproductive medicine, 30(9), 289–297. https://doi.org/10.1016/j.ogrm.2020.06.005
Phillips, C., & Walsh, E. (2020). Group A Streptococcal infection during pregnancy and the postpartum period. Nursing for women's health, 24(1), 13–23. https://doi.org/10.1016/j.nwh.2019.11.006
Plante, L. A., Pacheco, L. D., & Louis, J. M. (2019). SMFM Consult Series #47: Sepsis during pregnancy and the puerperium. Am J Obstet Gynecol, 220(4): B2-B10. https://doi.org/10.1016/j.ajog.2019.01.216.
Ramírez Salinas, Y., Illas, A. Z., Infante del Rey, S., Ramírez Salinas, Y. M, Castellanos, I. M., & Mayor, V. M. (2016). Infección del sitio quirúrgico en puérperas con cesárea. Revista Cubana de Obstetricia y Ginecología, 42(1).
Shafik, S., Mallick, S., Fogel, J., Tetrokalashvili, M., & Hsu, C. D. (2019). The utility of systemic inflammatory response syndrome (SIRS) for diagnosing sepsis in the immediate postpartum period. J Infect Public Health, 12(6), 799–802. https://doi.org/10.1016/j.jiph.2019.04.003
Silva, J. V. C. P., Santos, L. A., Pontes, L. T. A., Vasconcelos, T. H., Teodósio, D. de O., & Melo, G. B. (2020). Fatores de risco e complicações relacionados à mortalidade materna. Caderno de Graduação, 6(2), 87-100.
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J.-D., Coopersmith, C. M.; Hotchkiss, R. S., Levy, M. M., Marshall, J. C., Martin, G. S., Opal, S. M., Rubenfeld, G. D., van der Poll, T., Vicent, J.-L., Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA, 315(8), 801–810. https://doi.org/ 10.1001/jama.2016.0287
Viderman, D., Umbetzhanov, Y., Temirov, T., & Kuzkov, V. V. (2021). Refractory gram-negative septic shock complicated by extended purpura fulminans and multiple organ failure in a 23-year-old puerpera -a case report. Korean journal of anesthesiology, 74(3), 266–270.
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Copyright (c) 2021 Antonio Paulo Nunes da Silva; Pollyana Rodrigues Diniz; Polyana Felipe Ferreira da Costa; Pauliana Valéria Machado Galvão; Valda Lúcia Moreira Luna; George Alessandro Maranhão Conrado
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