World Sepsis Day 2023 – Together we can end maternal sepsis

Every 4 minutes, a woman dies from a sepsis-related cause somewhere in the world, with the greatest burden borne by women in low- and middle-income countries.

On World Sepsis Day, join our efforts to raise awareness about maternal sepsis and help us disseminate our new video

We are testing effective strategies to prevent and manage maternal sepsis in Malawi and Uganda, via an integrated programme including hand hygiene, optimized use of antibiotics and improved surgical practices, and improved maternal sepsis management. This programme responds to the 70th World Health Assembly resolution Improving the prevention, diagnosis and clinical management of sepsis and the Global Maternal and Neonatal Sepsis Initiative objectives.

 

4th World Sepsis Congress – 2023: Maternal Sepsis: Why Is It Still in the Top 3 for Global Incidence of Sepsis?

On April 25-26, the Global Sepsis Alliance (GSA) hosted the 4th World Sepsis Congress “ONE GLOBAL HEALTH THREAT: SEPSIS, PANDEMICS, AND ANTIMICROBIAL RESISTANCE”.

The 4th WSC featured 16 sessions across 2 days, including a session on maternal sepsis entitled MATERNAL SEPSIS: WHY IS IT STILL IN THE TOP 3 FOR GLOBAL INCIDENCE OF SEPSIS?,  co-organized by GSA and WHO.

 

You can access the recording of this session using the links below:

Direct YouTube link: https://www.youtube.com/watch?v=XrsiBzkgksQ

Podcast link: https://podcasts.apple.com/us/podcast/4th-world-sepsis-congress/id1155062518

 

An Epidemiology-Based Assessment of the Problem – Alan Tita, University of Alabama at Birmingham, United States of America

Sharing the Story from Malawi – Video

Sepsis Awareness and the Importance of Advocacy: Perspective of a Midwife and Sepsis Survivor – Helen Cheyne, University of Stirling, United Kingdom

Early Detection and Management: What Does It Mean for Maternal Sepsis? – Maria Fernanda Escobar Vidarte, The International Federation of Gynecology and Obstetrics, Colombia

Can Changing the Health System’s Approach Improve Maternal Sepsis Outcomes in Argentina and Beyond? – Edgardo Abalos, Independent Researcher, Argentina

Can Changing the Health System’s Approach Improve Maternal Sepsis Outcomes in Lebanon and Beyond? – Sabina Abou Malham, Université de Sherbrooke, Canada

The Perspective of the World Health Organization – Benedetta Allegranzi, World Health Organization, Switzerland

Infection-related maternal deaths and near-miss in 11 GLOSS countries

A recent paper published in BMC Pregnancy and Childbirth used data from 15 facilities across 11 GLOSS countries to conduct a virtual confidential inquiry to understand factors linked to infection-related maternal deaths and near-miss. The paper also provides with suggested actions, including the implementation of virtual platforms to improve routine adoption of confidential reviews.

To read the full article, please click here.

Remember to visit our resources page for other resources to use in your facilities.

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Abstract

Background: Obstetric infections are the third most common cause of maternal mortality, with the largest burden in low and middle-income countries (LMICs). We analyzed causes of infection-related maternal deaths and near-miss identified contributing factors and generated suggested actions for quality of care improvement.

Methods: An international, virtual confidential enquiry was conducted for maternal deaths and near-miss cases that occurred in 15 health facilities in 11 LMICs reporting at least one death within the GLOSS study. Facility medical records and local review committee documents containing information on maternal characteristics, timing and chain of events, case management, outcomes, and facility characteristics were summarized into a case report for each woman and reviewed by an international external review committee. Modifiable factors were identified and suggested actions were organized using the three delays framework.

Results: Thirteen infection-related maternal deaths and 19 near-miss cases were reviewed in 20 virtual meetings by an international external review committee. Of 151 modifiable factors identified during the review, delays in receiving care contributed to 71/85 modifiable factors in maternal deaths and 55/66 modifiable factors in near-miss cases. Delays in reaching a GLOSS facility contributed to 5/85 and 1/66 modifiable factors for maternal deaths and near-miss cases, respectively. Two modifiable factors in maternal deaths were related to delays in the decision to seek care compared to three modifiable factors in near-miss cases. Suboptimal use of antibiotics, missing microbiological culture and other laboratory results, incorrect working diagnosis, and infrequent monitoring during admission were the main contributors to care delays among both maternal deaths and near-miss cases. Local facility audits were conducted for 2/13 maternal deaths and 0/19 near-miss cases. Based on the review findings, the external review committee recommended actions to improve the prevention and management of maternal infections.

Conclusion: Prompt recognition and treatment of the infection remain critical addressable gaps in the provision of high-quality care to prevent and manage infection-related severe maternal outcomes in LMICs. Poor uptake of maternal death and near-miss reviews suggests missed learning opportunities by facility teams. Virtual platforms offer a feasible solution to improve routine adoption of confidential maternal death and near-miss reviews locally.

Infection prevention and control in maternal and neonatal care training toolkit

WHO recently launched a new training course on infection prevention and control for maternal and neonatal care. The course is aimed at staff working in maternal and neonatal wards, specifically, antenatal care outpatient services, maternal and neonatal inpatient services, and neonatal intensive care services.

The course is divided into 6 sessions. The first session covers the essential knowledge of standard precautions required for good infection prevention and control. The other five sessions develop this knowledge and apply it clinically to common situations in antenatal care, labour, childbirth and neonatal care. Currently the first three sessions are available.

  • Module 1: Introduction to Infection prevention and control
  • Module 2: Care of the pregnant woman in antenatal clinic
  • Module 3: Admission of the pregnant woman, labour and uncomplicated childbirth
  • Module 4: When interventions are required in labour (in production)
  • Module 5: Caesarean section (in production)
  • Module 6: Special neonatal circumstances (in production)

Registration is open through openWHO.

 

World Sepsis Day 2021 and new GLOSS publication

On World Sepsis Day we renew our commitment to raise awareness of sepsis and increase efforts to reduce the worldwide burden of this life-threatening condition. Latest estimates pose that about 11 million people each year because of sepsis and evidence from GLOSS has shown the significant impact sepsis has on maternal mortality and morbidity. New evidence suggests that about one third of all births from women with infection were severe perinatal outcomes (neonatal near-miss or perinatal death).

Please help us amplify the messages around maternal sepsis and share the GLOSS-related publications widely:

Also visit our Resources page for other materials developed for the study and campaign.

 

New GLOSS publication: an analysis of study facilities

A new paper on an analysis of GLOSS participating facilities was published in Lancet Global Health. It showed that availability of resources and services necessary to prevent, identify, and manage maternal infections in facilities that participated in GLOSS did not always result in better maternal outcomes. In fact, it showed that individual women’s characteristics known to be associated with poor maternal outcomes, such as pre-existing conditions, are more probable predictors of severe outcomes than characteristics of a health facility (e.g. medical supplies and equipment).

To read the full article, please click here.

Remember to visit our resources page for other resources to use in your facilities.

 

 

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Abstract

Background: Infections are among the leading causes of maternal mortality and morbidity. The Global Maternal Sepsis and Neonatal Initiative, launched in 2016 by WHO and partners, sought to reduce the burden of maternal infections and sepsis and was the basis upon which the Global Maternal Sepsis Study (GLOSS) was implemented in 2017. In this Article, we aimed to describe the availability of facility resources and services and to analyse their association with maternal outcomes.

Methods: GLOSS was a facility-based, prospective, 1-week inception cohort study implemented in 713 health-care facilities in 52 countries and included 2850 hospitalised pregnant or recently pregnant women with suspected or confirmed infections. All women admitted for or in hospital with suspected or confirmed infections during pregnancy, childbirth, post partum, or post abortion at any of the participating facilities between Nov 28 and Dec 4 were eligible for inclusion. In this study, we included all GLOSS participating facilities that collected facility-level data (446 of 713 facilities). We used data obtained from individual forms completed for each enrolled woman and their newborn babies by trained researchers who checked the medical records and from facility forms completed by hospital administrators for each participating facility. We described facilities according to country income level, compliance with providing core clinical interventions and services according to women’s needs and reported availability, and severity of infection-related maternal outcomes. We used a logistic multilevel mixed model for assessing the association between facility characteristics and infection-related maternal outcomes.

Findings: We included 446 facilities from 46 countries that enrolled 2560 women. We found a high availability of most services and resources needed for obstetric care and infection prevention. We found increased odds for severe maternal outcomes among women enrolled during the post-partum or post-abortion period from facilities located in low-income countries (adjusted odds ratio 1·84 [95% CI 1·05–3·22]) and among women enrolled during pregnancy or childbirth from non-urban facilities (adjusted odds ratio 2·44 [1·02–5·85]). Despite compliance being high overall, it was low with regards to measuring respiratory rate (85 [24%] of 355 facilities) and measuring pulse oximetry (184 [57%] of 325 facilities).

Interpretation: While health-care facilities caring for pregnant and recently pregnant women with suspected or confirmed infections have access to a wide range of resources and interventions, worse maternal outcomes are seen among recently pregnant women located in low-income countries than among those in higher-income countries; this trend is similar for pregnant women. Compliance with cost-effective clinical practices and timely care of women with particular individual characteristics can potentially improve infection-related maternal outcomes.[:]

GLOSS awareness campaign evaluation

We now have the results of the evaluation of the STOP SEPSIS! awareness campaign published! This is the campaign that accompanied GLOSS, which looked at the frequency and management of maternal infections in facilities. The GLOSS STOP SEPSIS! campaign aimed to increase awareness among healthcare providers.

To help us disseminate these news please use the links below:

Help us spread the word and help us STOP SEPSIS!

Save Lives campaign: Nurses and Midwives, clean care is in your hands!

Clean hands save lives! Today, 05 May 2020, is the global save lives campaign.

And on the year of the nurse and midwife the focus is on them. We are joining WHO in calling all health workers to join hands in celebrating nurses and midwives in the work that they do to keep our women and newborns safe by preventing health care-associated infections.

Find all the materials for this year’s campaign here.

And read the special news story on nurses and midwives saving lives.

GLOSS results are out!

The results from the global maternal sepsis study are out! The data on frequency and management of maternal infections obtained from 713 healthcare facilities in 52 countries have just been published. Te help us disseminate these results please use the links below.

Help us spread the word and help us STOP SEPSIS!

Raising global awareness on maternal sepsis

Our collective efforts to raise awareness on maternal sepsis did not end with the GLOSS awareness campaign. Our colleagues from Philippines describe what they have been doing country-wide in the latest edition of the Obstetrics and Gynaecology Magazine published by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Follow this link to learn more about what has been learned through GLOSS and done since to stop sepsis: https://www.ogmagazine.org.au/21/4-21/raising-global-awareness-on-maternal-sepsis/

You can access the entire issue following this link: https://www.ogmagazine.org.au/category/21/4-21/