PAHO webinar highlights early detection and timely management of maternal sepsis to reduce preventable maternal deaths

Washington, D.C., 11 June 2025 (PAHO) - The Pan American Health Organization (PAHO) held a webinar on the clinical management of maternal sepsis, underscoring the urgent need to strengthen early detection and timely treatment of one of the leading causes of maternal morbidity and mortality worldwide.

The webinar, titled, "Update on the Clinical Management of Maternal Sepsis", brought together regional experts to review current evidence, share practical approaches for identifying maternal sepsis, and discuss critical interventions to improve outcomes for pregnant, post abortion and postpartum women.

Dr. Suzanne Serruya, Life Course, Women's and Children's Health Unit Chief at PAHO/WHO highlighted that maternal sepsis remains a major contributor to preventable maternal deaths. Additionally, she emphasized the importance of strengthening the capacities of health personnel to recognize and respond to the condition as early as possible.

Recognized by the World Health Organization as a public health priority, maternal sepsis continues to be a central of regional efforts to accelerate reductions in maternal mortality. Through initiatives such as the Call to Action: Zero Preventable Maternal Deaths in the Americas, PAHO continues to support countries in improving the quality of maternal care and strengthening the management of obstetric emergencies.

Evidence shows significant reductions in maternal deaths

During the webinar, Dr. João Paulo Souza, Director of the Latin American and Caribbean Center on Health Sciences Information, presented findings from a cluster randomized clinical trial conducted in 59 hospitals in Malawi and Uganda, where 431,394 women gave birth during the trial. The study demonstrated a 32% reduction in maternal mortality and severe maternal morbidity related to infection through the implementation of a multicomponent intervention package.

The Active Prevention & Treatment of Maternal Sepsis (APT-Sepsis) package combined infection prevention (emphasizing hand hygiene), early sepsis recognition, and prompt management via the FAST-M bundle (fluids, antibiotics, source control, referral, and monitoring), supported by institutional leadership and monitoring systems. According to Dr. Souza, this is a low-cost intervention requiring no new technology, but the challenge is adapting it to the diverse Latin American and Caribbean context, where leverage points and scaling differ from Africa's..

Recognizing maternal sepsis before it becomes critical

Experts Dr. José Antonio Rojas, Professor of the postgraduate program in Critical Care Medicine at the University of Cartagena and Director of the Intensive Care Unit at Clínica Gestión Salud, ESE Clínica de Maternidad Rafael Calvo, and Dr. Mauricio Vasco, Coordinator of the Obstetric Anesthesia Committee of the Latin American Confederation of Obstetric Anesthesia. CLASS. Professor at the Faculty of Medicine of CES University, emphasized that maternal sepsis should be understood as a life-threatening condition involving organ dysfunction resulting from infection during pregnancy, childbirth, post-abortion, or the postpartum period.

Speakers stressed that health professionals should not wait for maternal sepsis to occur before initiating treatment. Instead, recognizing subtle signs of deterioration, including persistent tachycardia, altered perfusion, reduced urine output, and progressive clinical decline, is essential for timely intervention.

The discussion also highlighted the need to interpret symptoms within the context of the physiological changes of pregnancy and to identify potential sources of infection, ranging from urinary tract infections to postpartum or post-abortion infections.

The critical importance of the first hour

A central theme of the webinar was the importance of acting quickly once maternal sepsis is suspected.

Presenters reviewed evidence showing that implementation of key interventions during the first hour can substantially reduce mortality, while delays in treatment significantly increase risk. Recommended actions include rapid assessment, administration of broad-spectrum antibiotics, appropriate fluid resuscitation, identification of the infection source, and timely referral when higher levels of care are required.

Experts also discussed the role of early warning systems and screening tools across different levels of care, from community settings to hospitals. While these tools can support detection, speakers emphasized that they should complement, not replace-clinical judgment and locally adapted protocols.

Strengthening health systems and continuous care

Beyond clinical management, experts highlighted the importance of institutional leadership, multidisciplinary teamwork, referral networks, and ongoing monitoring to improve outcomes for women with severe infections.

As part of PAHO's efforts to support capacity-building in maternal health, participants were also invited to access a free virtual course on the care of obstetric critically ill patients, available on PAHO's Virtual Campus for Public Health.

The webinar concluded with a call to strengthen continuous care throughout pregnancy, childbirth, and the postpartum period, ensuring that health services are prepared to identify and respond to maternal sepsis promptly and effectively.