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Table 2 List of criteria used to identify maternal sepsis in studies and guidelines included in the systematic review

From: Towards a consensus definition of maternal sepsis: results of a systematic review and expert consultation

System Variable Values or ranges (min - max) References studies References guidelines Other signs Other symptoms
Circulatory Heart rate >90/min
(90–120/min)
or > 2 SD above the normal value for age
[2,21,22,29,38,, 4, 5, 10, 12, 2023, 26, 2831, 33, 35, 36] [13,44,45,46,, 40, 4246] Vasoplegia [34] -
  Blood pressure SBP <100 mmHg
MAP <70 (65–70) mm Hg
Decrease SBP >40 mmHg
[4, 12, 20, 22, 23, 28, 30, 31, 35, 36] [13,46,, 40, 41, 4446] Significant oedema/positive fluid balance [12, 20, 23, 35, 36, 43, 47] -
Respiratory Respiratory rate >20/min
(≤10 or ≥ 25/min)
[2,38,39,, 4, 5, 10, 12, 21, 26, 29, 31, 3537] [13,46,, 40, 42, 4446] Marked tachypnea, Acute lung injury in the absence of pneumonia as infection source [12, 22, 29, 36, 38] Cough, sore throat [4, 25], chest pain [41]
Arterial blood gases PaO2/FIO2 <40kPa [2023] [43]
Central Nervous System Altered mental status Glasgow Coma scale <14/15 - [46] Confusion, decreased alertness, prostration, unduly anxious, distressed or panicky [4,42,43,44,45,46,47,, 13, 24, 25, 4047] Headache, pain, lethargy, body pain, arthralgia, myalgia [4, 24, 25, 30]
  Hyperthermia >38 °C
(37.8–38.5 °C)
[2,21,22,29,35,36,37,38,, 4, 5, 10, 12, 2023, 26, 2831, 3336] [13,45,46,, 40, 4346, 49] - Fever, Chills [28, 30, 33]
  Hypothermia <36 °C
(35.5 °C – 36 °C)
[2,21,22,37,38,, 4, 5, 10, 12, 2023, 26, 2931, 3336] [13,45,, 40, 4345] - -
Renal Lactate (mmol/L) >1 (>1–4) [8, 12, 20, 22, 23, 25, 35] [13, 40, 42, 43, 45] Acute oliguria, anuria [10, 12, 20, 22, 24, 25, 29, 35, 36] Urinary symptoms [4, 25, 27], renal angle pain and tenderness [41]
  Kidney (Creat mg/dL) >2 mg/dL or
Raise > 0.5 mg/dL
[8, 12, 20, 22, 23, 25, 29, 33, 35, 37] [41]
Coagulation Platelets (/ml) <100,000 [8, 12, 20, 22, 23, 35] [13, 40, 41, 43, 46] - Coagulopathy, Disseminated intravascular coagulation [8, 34, 37, 38]
   INR >1.5 or aPTT >60 s [12, 20, 22, 23, 25, 29, 35] [13, 4044, 46, 47]
Digestive Glucose (mmol/L) >7.7 in the absence of DM [12, 20, 22] [13, 40, 43, 44] Mild intestinal tenderness without rebound tenderness
Peritonitis [4, 25, 27, 30]
Ileus [12, 20, 22, 23, 35, 36]
Reduced appetite, Nausea, Vomiting, diarrhea, abdominal pain [4, 10, 25, 27, 31]
  Liver: total bilirubin (mmol/L) >2 mg/dL
>70 mmol/L
[8, 12, 20, 22, 23, 25, 29, 35] [13,42,43,44,, 4044, 47]
Skin - - - - Decreased capillary refill, clammed or mottled skin
Generalized erythematous macular rash, Rash, erythema [4, 28, 38]
Necrotizing fasciitis or myositis
Gangrene [8,39,, 10, 12, 20, 22, 23, 27, 3538]
-
Genital - - - - Pus or foul-smelling fluid from the cervix, pyometra, cervicitis, metrorrhagia, delay in the rate of reduction of size of uterus [10, 21, 24, 27, 28, 30, 31] Purulent vaginal discharge [30, 31] pelvic pain, [10, 21, 24, 27, 28, 30]
Inflammatory WBC(cells/μl) >12000 (11000–16000) or <4000 or >10% immature forms [2,21,22,29,37,38,, 4, 5, 10, 12, 2023, 25, 26, 2830, 3336] [13,42,43,44,45,46,47,, 4047] Preterm labour [25] Breast redness,
Pain of site of infection [4, 10, 22, 25]
CRP >7 mg/L
>2SD
[12, 20, 22, 23, 29, 35] [13,42,43,44,, 4044, 47]
Procalcitonin >2SD [20, 22, 23, 35] [43, 47]
Other Culture Positive [8, 10, 24, 32, 38] - - -
Fetal distress - - - Fetal distress secondary to maternal acidosis [45] Reduced or absent fetal movements [45]
  1. CRP C-reactive protein, FIO2 fraction of inspired oxygen, MAP Mean Arterial Blood Pressure, PaO2 arterial oxygen partial pressure, SBP Sistolic Blood Pressure, WBC White Blood Cell Count