Prevention Strategy for Maternal Sepsis
Screening for asymptomatic bacteriuria for prevention of pyelonephritis (option c) is the correct prevention strategy for maternal sepsis.
Why This is the Correct Answer
While the provided evidence focuses primarily on recognition, diagnosis, and management of established maternal sepsis rather than primary prevention strategies, screening for asymptomatic bacteriuria represents a well-established preventive measure in obstetric care. Untreated asymptomatic bacteriuria in pregnancy can progress to pyelonephritis, which is a known source of maternal sepsis 1, 2.
Why the Other Options Are Incorrect
Option A: Prophylactic Antibiotics 120 Minutes Prior to Cesarean
- The timing is wrong - standard practice calls for prophylactic antibiotics within 60 minutes (not 120 minutes) before skin incision for cesarean delivery 2
- While antibiotic prophylaxis for cesarean delivery does prevent surgical site infections, the 120-minute timeframe makes this option incorrect
Option B: Vaginal Prep Prior to Vaginal Delivery
- Vaginal preparation before vaginal delivery is not a standard prevention strategy for maternal sepsis 2
- The evidence does not support routine vaginal antiseptic preparation for preventing sepsis in vaginal deliveries
Option D: Handwashing by Patients During Second Stage of Labor
- While hand hygiene is important for healthcare providers, patient handwashing during active labor (second stage) is not a recognized sepsis prevention strategy 2
- This would be impractical during active pushing and is not evidence-based for sepsis prevention
Key Prevention Principles
Early recognition and screening are critical because approximately half of maternal sepsis cases occur in the postdischarge postpartum period, making outpatient recognition crucial 3. Maternal sepsis is the second leading cause of preventable maternal mortality 3.
Prevention focuses on: