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

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, 20–23, 26, 28–31, 33, 35, 36]

[13,44,45,46,, 40, 42–46]

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, 44–46]

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, 35–37]

[13,46,, 40, 42, 44–46]

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

[20–23]

[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, 40–47]

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, 20–23, 26, 28–31, 33–36]

[13,45,46,, 40, 43–46, 49]

-

Fever, Chills [28, 30, 33]

Hypothermia

<36 °C

(35.5 °C – 36 °C)

[2,21,22,37,38,, 4, 5, 10, 12, 20–23, 26, 29–31, 33–36]

[13,45,, 40, 43–45]

-

-

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, 40–44, 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,, 40–44, 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, 35–38]

-

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, 20–23, 25, 26, 28–30, 33–36]

[13,42,43,44,45,46,47,, 40–47]

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,, 40–44, 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]