• Early identification of life-threatening organ dysfunction caused by a dysregulated response to infection in pregnancy.
• Triaging septic pregnant/postpartum women for mass volume resuscitation and ICU admission.
• Differentiating normal physiologic changes of pregnancy from true systemic decompensation.

• Requires 2 out of 3 criteria:
• Respiratory Rate ≥ 22 breaths/min
• Altered Mental Status (GCS < 15)
• Systolic BP ≤ 100 mmHg

To avoid over-admitting healthy pregnant women who naturally map near these limits, the Sepsis in Obstetrics Score (SOS) and local MEWS (Maternal Early Warning Systems) adjust the baseline. For tracking maternal morbidity, maternal tachycardia >110 bpm and fetal tachycardia >160 bpm are extremely sensitive early warning signs of overwhelming maternal infection like chorioamnionitis.

• Healthy young pregnant women have phenomenal cardiovascular reserve. They will compensate drastically to protect core perfusion, looking deceivingly stable until they suddenly "fall off a cliff" into refractory shock.
• Urine output dropping below 30 mL/hr is often the absolute first sign that central compartment shunting is occurring at the expense of end-organs.
• Fetal tachycardia (>160 bpm) is frequently the absolute earliest manifestation of maternal systemic inflammation, sometimes preceding maternal fever by hours.

• 1. Give High Flow Oxygen (maintain maternal SpO2 >95% to protect fetal oxygen gradient).
• 2. Take Blood Cultures (before broad spectrum IV antibiotics).
• 3. Give IV Antibiotics (Broad spectrum, e.g., Ceftriaxone & Metronidazole; escalate to Piperacillin-Tazobactam if critically ill).
• 4. Give IV Fluids (Aggressive crystalloid resuscitation, up to 30 mL/kg for hypotension).
• 5. Check Serum Lactate.
• 6. Monitor strict hourly urine output via Foley catheter.

Puerperal fever (postpartum sepsis) historically decimated maternities. Semmelweis discovered the cure—handwashing—in 1847, but he was mocked by the medical establishment. Today, Streptococcal pyogenes (Group A Strep) remains a terrifying, rapidly fatal cause of postpartum sepsis.