What is sepsis?

Sepsis is when your body responds to an infection in a way that causes damage to body cells and tissue. It is a medical emergency since it can lead to organ failure or even death. It can be hard to tell that you have sepsis until it is bad. It might become serious quickly since the changes that occur in pregnancy can cover up early changes that happen when you have sepsis. Sepsis can also cause septic shock, which is when your blood flow decreases and body cells don’t work normally. This increases the risk of death.

If you’re pregnant, sepsis can reduce blood flow to your placenta and baby, causing your baby to be stressed.

What are symptoms of sepsis during pregnancy or after birth?

There are many different symptoms that could be caused by sepsis. Your symptoms might be vague and non-specific such as:

• fevers or chills
• being confused or drowsy
• unexplained stomach pain or distension
• a fast heart rate
• breathing fast
• your baby having a fast heart rate (if you are pregnant)

Sometimes the symptoms can be specific to where the infection may have started such as:

• pain when passing urine
• passing urine more often than usual
• pain where you have an intravenous (IV) drip or a catheter
• coughing, breathlessness or sputum
• wound infection
• vomiting and diarrhoea
• breast infection

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes sepsis during pregnancy or after birth?

Sepsis in pregnancy and after birth can be due to pregnancy-related infections such as infections in the amniotic fluid and placenta, infection in the pelvis or a wound infection after a caesarean section or perineal tear. Infections that anyone may experience can also occur in pregnancy and lead to sepsis such as pneumonia or urinary tract infections (UTIs).

The infections that cause sepsis can be bacterial and/or viral.

When should I see my doctor?

You should see your doctor as soon as possible if you have any fevers, symptoms of infection or are feeling unwell at any time in pregnancy or soon after your baby is born.

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Are there risk factors for sepsis during pregnancy or after birth?

Changes to your body that happen in pregnancy and are risk factors for sepsis in pregnancy and after birth include:

• diabetes
• being immunocompromised
• low haemoglobin (anaemia)
• living with obesity

Pregnancy-related risk factors include:

• having a cervical stitch or amniocentesis
• prolonged rupture of membranes (when there is a long time between your waters breaking and your baby being born)
• having a long labour
• previous infection in the pelvis
• previous group A streptococcus infection
• having placental tissue left in the uterus after birth

Can sepsis be prevented?

Sepsis can be prevented by avoiding infections. Some steps you can take include:

• getting your flu vaccination
• ensuring you and your health-care professionals have clean hands
• bathing regularly
• staying away from people who are sick with an infection that could spread

How is sepsis treated during pregnancy?

It is important to treat sepsis quickly including starting antibiotics straight away. Your healthcare team may take blood tests, wound swabs and/or a urine sample to check what infection you have. You may also have an x-ray or an ultrasound.

You may need fluids into your vein through a drip to improve your blood pressure and blood flow to your organs. You will receive antibiotics specific for the infection the doctors think you have. If the cause isn’t clear, you will need more than one type of antibiotic to treat different possible infections. Once the cause is confirmed, your doctors will give you a specific antibiotic, and in some situations an antiviral medicine.

If you are pregnant, you baby will be monitored with a cardiotocograph (CTG) — this is a device that measures heart rate. Sometimes, your baby will need to be born sooner than expected. It is possible that you will need to stay in the intensive care unit for specialised care if you are very unwell with sepsis. If you have retained placenta in your uterus or a wound infection you may need surgery.

Both pregnancy and sepsis increase the risk you developing a blood clot. You will be given a blood thinning medicine to reduce this risk.

Is there any risk to my baby if I have sepsis during pregnancy?

Having a fever in pregnancy may increase the risk of birth differences (congenital anomalies). When you have sepsis, your doctors will consider the risks and benefits of waiting for your baby to be born on time, depending on:

• how many weeks pregnant you are
• the type of infection you have
• if you are getting better with treatment
• how well your baby is, based on CTG monitoring

If your baby is going to be born early, you may need medicine injections to help your baby’s lungs mature before birth. Your baby will usually receive antibiotics after birth and may need to spend some time in the special care nursery or neonatal intensive care unit (NICU).

Are there any complications of sepsis during pregnancy or after birth?

Sepsis is one of the biggest causes of maternal death in Australia, even though overall numbers are very low (around 5 deaths for every 100,000 pregnancies).

Around 1 in 2 adults with sepsis has problems that continue for months or years afterwards, such as feeling tired, trouble concentrating, pain or trouble walking. Your kidney, lung and heart function may also be reduced. Sometimes sepsis causes permanent disability such as losing a limb. Some people develop post-traumatic stress disorder or anxiety after having sepsis.

Will having sepsis affect future pregnancies?

Sepsis in one pregnancy can affect future pregnancies if there is long-term damage to your organs or if surgery is involved.

If you have a caesarean section because your baby needed to be born early or urgently, it can affect how your future babies will be born. Your doctor will discuss the recommended time to wait before having another baby and the risks of vaginal birth after caesarean section.

If you have some placental tissue that remains in the uterus and is causing the infection, your doctor may recommend surgery. The surgery has a small risk of causing scarring to the lining of the uterus. If the scarring is bad enough, it can stop you from becoming pregnant in the future. There is a surgery that can help remove the scar tissue.

Resources and support

The Australian Commission on Safety and Quality in Health Care has several resources about sepsis:

• Spotlight on Sepsis video explains more about sepsis and when to seek help.
• Spotlight on Sepsis video for Aboriginal and/or Torres Strait Islander people.
• Fact sheet about sepsis.