Sepsis in pregnant women and babies
Sepsis, also known as septicaemia or blood poisoning, is a life-threatening illness caused when the body is overcome by infection. It can be successfully treated if the symptoms are recognised quickly and emergency hospital treatment is sought
Sepsis is a serious condition which anyone can develop, however, it is more of a risk for newborn babies, pregnant women, elderly people and people with compromised immune systems – for example, if they are receiving chemotherapy. Sometimes called 'the silent killer', it claims more lives annually than bowel, breast and prostate cancer combined. Headlines about the condition often focus on doom and gloom – but fear not – if spotted and treated quickly, the chances of a full recovery are high.
Signs of sepsis in pregnancy
Sepsis is a risk if you’re pregnant, as your immune system is weakened by your growing baby. Sepsis that occurs in pregnancy is known as maternal sepsis. If it develops within six weeks of giving birth, when your immune system is still weakened, it is referred to as postpartum sepsis. It can be difficult to spot sepsis if you're pregnant, as the symptoms can be vague or related to other conditions. If you have any of the following symptoms, it's recommended that you get checked over.
Early symptoms of sepsis may include:
- A high temperature (fever) or low body temperature
- Chills and shivering
- A fast heartbeat
- Fast breathing
In some cases, symptoms of more severe sepsis or septic shock (when your blood pressure drops to a dangerously low level) develop soon afterwards. Don't panic, but seek medical help as soon as possible if you experience this symptoms:
- Feeling dizzy or faint
- A change in mental state – such as confusion or disorientation
- Nausea and vomiting
- Slurred speech
- Severe muscle pain
- Severe breathlessness
- Less urine production than normal – for example, not urinating for a day
- Cold, clammy and pale or mottled skin
- Loss of consciousness
I believe the hospital never took on board how ill I was at first. I was left to look after DD alone while I was having violent shaking episodes and a temperature of 40 – but I felt stone cold. I had to change and feed her while attached to a drip.
What causes sepsis during pregnancy?
If you’re pregnant and feeling a bit under the weather, then it is most likely to be nothing serious and you will recover normally. However, it’s important to know what to do if something more serious is afoot. Pop along to your GP or midwife to get yourself checked over because even if it’s nothing serious they can help. You won’t be wasting anyone’s time and it is their job to help you.
Sepsis is an unlikely outcome of illness and can occur because of an infection. This can either be related or unrelated to the pregnancy, such as if you contract pneumonia or a urinary tract infection. It can also develop if you’ve had a miscarriage, c-section, prolonged labour, or mastitis. These will increase your risk of sepsis, but be assured that not everyone who has these conditions will go on to develop it
What should I do if I am pregnant and think I have sepsis?
If you have recently had an infection and you are showing any of these possible signs, you should seek medical advice urgently from NHS 111. If sepsis is suspected by your GP or the 111 operator, you'll usually be referred to hospital for further diagnosis and treatment. Sepsis can develop very quickly, so don’t hang around. It can be complicated to get a diagnosis for sepsis if you’re pregnant because the symptoms can be related to another condition or simply pregnancy itself according to the NCT, but don't hesitate to ask for a referral or to be seen by a senior doctor.
What are the signs and symptoms of sepsis in babies?
If your baby has an infection, it will more than likely clear up, either on its own or with treatment from your GP. It's unlikely it will develop into something more serious. But it's still useful to know some of the early symptoms of sepsis, so you know what to look out for.
The UK Sepsis Trust recommends that you should keep a close eye on the “amber” symptoms – which are potential early signs of sepsis. If your baby displays any of the following, you should phone your GP or NHS 111:
- Raised temperature
- Crackly breathing
- Chills or shivers
- Refusing milk or food, or finding drinking and eating difficult
- Has been sick or had diarrhoea more than twice in the last 24 hours
- Unusually sleepy
- Swelling of joints
- Decreased urine output (only one wee in eight hours)
These symptoms are also those of a less severe infection, so don't panic if you see one or two. Just keep an eye out to see if your baby gets worse, or is displaying multiple signs.
You should dial 999 if your child has any of the following “red flag” symptoms. It's important to remember that symptoms can appear in any order or at the same time, and some symptoms may not appear at all:
- Not passing urine for more than 12 hours
- Fitting or convulsing
- A temperature of 38 degrees or higher in babies under three months
- A temperature of 39 degrees or higher in babies aged from three to six months
- Alternatively, abnormally low temperature – below 36 degrees. Check three times in 10 minutes.
- “Sunken” eyes
- Bulging soft spot (fontanelle)
- Fast breathing, which is defined as one breath per second in newborns
- Looks mottled, bluish or pale
- A racing pulse
- Fails to show interest in anything – eating, drinking, playing, stimulation
- Tired, listless and sluggish
- Rash that does not fade when pressed with a glass
- Difficulty or rapid breathing that sounds like a lamb bleating
- Difficult to rouse, floppy
- Vomit that is green, bloody or black
- Unable to keep fluids down
- Stiff neck
- Baby doesn’t seem to recognise you
What should I do if I think my baby has sepsis?
Sepsis can be hard to spot as the symptoms can also be signs of a common or less severe illness. If your baby has an infection and displays any of the above symptoms, or she seems to be getting worse, the UK Sepsis Trust recommends that you don't delay getting urgent medical treatment. The symptoms of sepsis can be confused with other infections, so it’s always best to know for sure.
Trust your instincts – if something just doesn't seem “right” when your baby is ill, it's good to get her checked, just to be on the safe side. Mention to your GP that you are concerned about sepsis so that they are aware of your concerns too. Everyone knows that GPs are busy people; it shouldn't happen, but sometimes things do get overlooked. They can check and will be happy to see any newborn with worried parents. If your baby is found to have sepsis, they will be admitted to hospital for treatment with antibiotics.
Meningitis, a medical emergency in its own right, can lead to septicaemia, so if you think your baby has the symptoms of meningitis, head down to hospital to get checked over.
How is sepsis treated?
Treatment will be similar for pregnant women and babies, as well as for other people who develop the condition. The aim is to treat the infection and support the body's functions while this takes place.
The treatment, whether for an adult or a baby, will vary depending on the site and cause of the initial infection, the organs affected and the extent of any damage. If sepsis is detected early and medical tests determine that it hasn't affected vital organs yet, then the infection may be treated at home with antibiotics.
Some people may require treatment in intensive care. However, prompt treatment with antibiotics is often effective and people who are otherwise healthy will normally go on to make a full recovery.
Sepsis is managed by a procedure known as the “sepsis six” – which is a combination of three tests and three treatments. This should be started by the healthcare team within an hour of diagnosis.
Treatment for sepsis involves:
- Intravenous fluids
- Oxygen treatment – if levels are low
Tests will include:
- Taking blood cultures – to diagnose which bacteria is causing the sepsis
- Taking a blood sample – to see how severe the sepsis infection is
- Monitoring urine output – to check kidney function and see how serious the infection is
If sepsis is severe, or you or your baby develops septic shock (where their blood pressure drops dangerously low), emergency treatment will be required. Severe sepsis and septic shock are medical emergencies that can be fatal, especially if the early signs of sepsis are not recognised and treated promptly.
This might all seem rather frightening, particularly as being pregnant or a parent are paths beset with worry. Don’t let it overwhelm you – if sepsis does develop, for you or your baby, specially trained medical staff will be on hand in hospital and the odds are stacked in favour of a full recovery.
Recovering from sepsis
The majority of people who receive prompt treatment will make a full recovery from sepsis quickly. The exact amount of time it takes depends on a few factors, including:
- Severity of the sepsis
- The overall health of the baby or person
- How much time was spent in hospital
- Whether treatment in intensive care was needed
Occasionally, some sufferers will experience long-term physical and/or psychological problems during their recovery period. These symptoms are known as post-sepsis syndrome. Not everyone who has sepsis will experience these problems, which include:
- Feeling lethargic or excessively tired
- Muscle weakness
- Swollen limbs or joint pain
- Chest pain or breathlessness
How many people survive sepsis?
A baby or a pregnant woman who receives prompt treatment stands a strong chance of a full recovery.
What Mumsnetters say about sepsis
“I nearly lost one of my children from it. He was just over a year old and and became ill overnight, it seemed like just a normal winter infection. I was expecting a call saying it was a normal childhood illness, but instead I was told to get to A&E straight away. It took him a couple of hours to go completely downhill and for the rash to cover him. Luckily a doctor put him on broad spectrum antibiotics while they were running tests.”
“DD was admitted with suspected septicaemia last year. I knew the signs and she was admitted straight away. Her temp was 40c, but her limbs and extremities were ice cold and she had very mottled skin and was very sleepy. They were fantastic and put an IV line in straight away with antibiotics. They said they didn't know if she had septicaemia but would treat her as if she did because she had many of the symptoms. Fortunately the blood tests came back negative and she was discharged the next day.”
“I hadn't heard of it until it happened to me, a week after giving birth. I had been feeling flu-like the whole time. I had violent shaking episodes one night, I was delirious and didn't know I was ill. I went to hospital and within 10 minutes, I was almost unconscious and attached to drips. It is not until recently that I realised just how ill I was – my doctor has told me I am very lucky to be here.”