Role of Sepsis in Obstetric Score (SOS) to identify severe sepsis in pregnant women requiring ICU admission: A prospective observational study

Title : Role of Sepsis in Obstetric Score (SOS) to identify severe sepsis in pregnant women requiring ICU admission: A prospective observational study

Abstract:

Introduction: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Obstetric sepsis is a significant contributor to maternal and perinatal morbidity and mortality, especially in low-income countries. Several scoring systems can help in identifying sepsis and its severity; however, their application in the obstetric population is not well-defined because of the altered physiology of pregnancy. The Sepsis in Obstetrics Score (SOS) is designed specifically for the obstetric population to identify the likelihood of the need for critical care admission for the obstetric population presenting with signs of sepsis.
Aim: To determine whether the SOS can be used to identify the severity of sepsis.
Materials and Methods: This was a prospective observational time-bound study conducted at Gandhi Hospital, Secunderabad, Hyderabad, Telangana, India, on 100 subjects that included pregnant women, postpartum women within six weeks, and postabortal women within two weeks of abortion with suspected obstetric sepsis presenting to Gandhi Hospital. SOS score was calculated for all study participants and grouped into scores of <6 and ³6. Organ failure was assessed. SOS score was associated with culture positivity, organ involvement, need for critical care support, and the severity of sepsis. Data were analysed using Statistical Packages for Social Sciences (SPSS) software, and appropriate statistical tests were applied; the p-value for significance was set at 0.05.
Results: The mean age of the study population was 25.48±5.13 years. Out of 100 women with obstetric sepsis, 50% had severe sepsis, graded by the presence of organ failure. When the cut- off score was considered as 6, SOS score had a sensitivity of 64% and specificity of 84%, a Positive Predictive Value (PPV) of 80.0%, a Negative Predictive Value (NPV) of 70.0%, and a diagnostic accuracy of 74.0% to detecting severe sepsis.
??????Conclusion: The findings emphasised the utility of the SOS score as a valuable tool for assessing the severity of illness, predicting outcomes, and guiding clinical management.

Biography:

Dr. Sangeeta Shah an accomplished academic and clinical professional with over 32 years of experience in teaching medical students and clinical practice in Obstetrics and Gynecology (OBG). She is currently serving as Additional Director of Medical Education and  Medical Superintendent , after an illustrious tenure as Professor & Hod of OBG at the prestigious government tertiary care centre namely, Gandhi Medical College and Hospital at Hyderabad- in the Southern Indian state of Telangana. 

Dr. Shah began her career as an Assistant Professor at Deccan Medical College, Hyderabad, in 1992, and subsequently worked at Osmania Medical College and Gandhi Medical College in various academic roles. In addition to her teaching roles, Dr. Shah has been an examiner for both postgraduate and undergraduate programs for over 25 years and has guided numerous post-graduate dissertations. She holds an MBBS from the prestigious and one of the oldest medical colleges of India, Osmania Medical College (1987) and an MD in Obstetrics and Gynecology (1992) from the same institution. Dr. Shah has published 40 articles in national and international indexed journals and is trained in laparoscopic surgery. She was honored for her exemplary services during the Covid pandemic by a Senior Judge of the City Civil Court. Dr. Shah is also a former state-level basketball player and an academic topper during her medical education as a postgraduate sttudent.