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. 2014 Sep;124(3):535-541.
doi: 10.1097/AOG.0000000000000423.

Maternal physiologic parameters in relationship to systemic inflammatory response syndrome criteria: a systematic review and meta-analysis

Melissa E Bauer  1 , Samuel T Bauer, Baskar Rajala, Mark P MacEachern, Linda S Polley, David Childers, David M Aronoff
Affiliations

Maternal physiologic parameters in relationship to systemic inflammatory response syndrome criteria: a systematic review and meta-analysis

Melissa E Bauer et al. Obstet Gynecol. 2014 Sep.

Abstract

Objective: To establish the normal maternal range in healthy pregnant women for each component of the systemic inflammatory response syndrome (SIRS) criteria and compare these ranges with existing SIRS criteria.

Data sources: PubMed, Embase, and ClinicalTrials.gov databases were searched to identify studies of healthy parturients from the first trimester through 12 weeks postpartum that reported maternal temperature, respiratory rate, PaCO2, heart rate, white blood cell count data, or a combination of these.

Methods of study selection: Data were extracted from studies providing maternal values for components of SIRS criteria. The mean, standard deviation, and two standard deviations from the mean for all criteria parameters published in the literature were reported.

Tabulation, integration, and results: Eighty-seven studies met inclusion criteria and included 8,834 patients and 15,237 data points: temperature (10 studies and 2,367 patients), respiratory rate (nine studies and 312 patients), PaCO2 (12 studies and 441 patients), heart rate (39 studies and 1,374 patients), and white blood cell count (23 studies and 4,553 patients). Overlap with SIRS criteria occurred in healthy pregnant women during the second trimester, third trimester, and labor for each of the SIRS criteria except temperature. Every mean value for PaCO2 during pregnancy (and up to 48 hours postpartum) was below 32 mm Hg. Two standard deviations above the mean for temperature, respiratory rate, and heart rate were 38.1°C, 25 breaths per minute, and 107 beats per minute, respectively.

Conclusion: Current SIRS criteria often overlap with normal physiologic parameters during pregnancy and the immediate postpartum period; thus, alternative criteria must be developed to diagnose maternal sepsis.

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References

    1. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al.. Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The eighth report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011;118(suppl):1–203.
    1. Bauer ME, Bateman BT, Bauer ST, Shanks AM, Mhyre JM. Maternal sepsis mortality and morbidity during hospitalization for delivery: temporal trends and independent associations for severe sepsis. Anesth Analg 2013;117:944–50.
    1. Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al.. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006;34:1589–96.
    1. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al.. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644–55.
    1. Lappen JR, Keene M, Lore M, Grobman WA, Gossett DR. Existing models fail to predict sepsis in an obstetric population with intrauterine infection. Am J Obstet Gynecol 2010;203:573.e1–5.

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