Maternal Infections And Sepsis During Pregnancy And Their Prevention

To embrace the heroic role of motherhood, it is essential to stay healthy through the period of pregnancy as well and avoid infection. A combination of physiological and immunological changes during pregnancy makes the women more susceptible to certain infections. The maternal immune system is globally suppressed during pregnancy in a way to accept the allogenic fetus. This maternal immunological adaptation is complex in a way to accept the allogenic fetus and also protect the mother and the future baby from various pathogens. Hence pregnancy contributes to an increased risk to infections. This increased risk of infections needs careful consideration and individualization of patient. In the first trimester of pregnancy up to 12 weeks’ urinary tract infections are more common due to endocrinological changes.

Dr Meenal Patvekar, Consultant Obstetrician and Gynecologist, DPU Super Specialty Hospital, Pimpri, Pune, says, “Pregnant women are immunosuppressed because the mother’s immune system has to be low to accept the fetus which is a foreign tissue in the maternal uterine environment. Maternal hormonal level changes during pregnancy and interplay between the sex hormones and the immune system may alter the efficiency of the maternal immune system. These changes contribute an increased susceptibility towards certain diseases.”

Pregnancy is a stressful change in any women’s body and any amount of external stress can also enhance or suppress and change the susceptibility and severity to certain infections. Pregnant women can have an increased incidence of contracting bacterial, parasitic, viral and fungal infections.

“A few examples being influenza, measles, respiratory, urinary tract infections, malaria and vaginal candidiasis. Infections can be transmitted vertically or trans placentally wherein the pathogen reaches the placenta through the mother’s blood or ascending infections through the external genitalia and vagina to the amniotic sac. If the infections are not recognized on time they can lead to a rare and extreme inflammatory condition called as sepsis. This sepsis during pregnancy or after birth is called maternal sepsis which is a life-threatening condition,” adds Dr Patvekar.

The risk of having maternal sepsis is increased if there is

– Prolonged labour

– Cesarean delivery

– Mastitis- infected milk ducts in the breast

– Small placental fragments remain in uterus after delivery

– Poor hand hygiene

– Severe anemia during pregnancy

– Diabetes mellitus during pregnancy

Any infection requires swift action and early intervention, Dr Patvekar shares measures that can help minimize the risk of infections and during pregnancy:

– Practice good personal hygiene.

– Wash hands regularly, especially before handling food.

– Refrain from sharing food, drinks, and utensils.

– Use condoms to prevent sexually transmitted infections.

– Avoid consuming raw foods like unpasteurized milk and stored food.

– Protect yourself from insect-borne diseases by wearing protective clothing and using nets in mosquito-infested areas.

– Avoid traveling to areas with high risks of Zika, dengue, and malaria.

– Limit contact with pets, such as cats, dogs, and sheep.

– Keep vaccinations up to date, including for flu, tetanus, hepatitis B, pertussis, and rubella.

– Regular antenatal care so as to identify conditions like anemia, diabetes mellitus which can make women more prone to infection.

– Consulting a health care provider at the earliest in case of fever, rigor and chills to prevent more complications.

How to reduce maternal sepsis?

1. Early diagnosis of infections
2. Consult your doctor if the following symptoms are present
3. Fever with chills
4. Foul smelling vaginal discharge
5. Giddiness
6. Fatigue
7. Decrease in urine output
8. Discolouration of skin
9. Regular antenatal care
10. Updated vaccination and booster
11. Post-partum visits

A healthy pregnancy is the foundation of a healthy baby and thus it is pivotal to curb any infections at the beginning of it so as to prevent maternal sepsis