O&G Cases · Postpartum care — infection and sepsis
Puerperal sepsis with suspected group A Streptococcus — recognise-and-treat station
Recognise-and-treat station: puerperal sepsis with pointers to invasive group A streptococcal disease. Tests the first-hour bundle with antibiotic names, the antitoxin role of clindamycin, source control, and the communication of a deteriorating patient. Includes assessor timeline, marking domains and assessor key.
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Station brief
Format. Recognise-and-treat station, approximately 12 minutes. You are the registrar on the postnatal ward. The assessor feeds you deteriorating observations. The hazard is the triage label "gastroenteritis" or "wound pain" — this woman has invasive group A streptococcal disease until proven otherwise, and the antibiotic must be given within the hour. [2]
Candidate instruction. Recognise and manage puerperal sepsis. Verbalise the bundle, the antibiotic regimen with the antitoxin addition, your source-control plan, your escalation to intensive care, and your communication with the woman and team. [1]
References4ShowHide
- [1]Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med, 2021.PMID 34599691
- [2]Mohamed-Ahmed O, Nair M, Acosta C, et al. Progression from severe sepsis in pregnancy to death: a UK population-based case-control analysis. BJOG, 2015.PMID 26213333
- [3]Mackeen AD, Packard RE, Ota E, et al. Antibiotic regimens for postpartum endometritis. Cochrane Database Syst Rev, 2015.PMID 25922861
- [4]Harris K, Proctor LK, Shinar S, et al. Outcomes and management of pregnancy and puerperal group A streptococcal infections: A systematic review. Acta Obstet Gynecol Scand, 2023.PMID 36636775