Gynecology World Conference 2026

Abstract

Pregnancy-associated sepsis (PAS) is responsible for a significant proportion of hospitalization of parturient in an intensive care unit and has considerable impact on maternal mortality. While the Quick Sequential Organ Failure Assessment (qSOFA) scoring system is a widely validated sepsis diagnostic tool and has been adapted for use within obstetric populations, the Sepsis in Obstetrics Score (SOS) was developed as a potentially more clinically relevant instrument in this cohort. With few data within the local clinical context, this prospective observational study of patients with PAS assessed and compared whether the ability of SOS or qSOFA to detect sepsis as well as prognosticate it could be validated by worldwide literatures in the Department of Obstetrics and Gynaecology at Chattogram Medical College Hospital, after obtaining ethical approval from institutional ethics committee.

Obstetric patients presenting with clinically suspected PAS were systematically enrolled upon satisfying predefined inclusion and exclusion criteria, and parameters pertaining to both scoring systems were recorded and analysed against defined clinical outcomes, namely intensive care unit (ICU) admission, hospital discharge, or in-hospital mortality. The mean age of the study participants was 25.7 ± 2.1 years. Among patients with SOS scores below the threshold of 6 (n = 35; 32.11% of the total cohort), the case fatality rate was 36.36% (n = 8), whereas among those with SOS scores ≥ 6 (n = 74; 67.89%), mortality was markedly elevated at 63.64% (n = 14). In the qSOFA analysis, patients with scores below 2 (n = 42; 38.53%) demonstrated a mortality rate of 45.45% (n = 10), while those with qSOFA scores ≥ 2 (n = 67; 61.47%) exhibited a mortality rate of 54.55% (n = 12).

With respect to predictive accuracy for in-hospital mortality, an SOS threshold of ≥ 6 yielded a sensitivity of 88% and a specificity of 83%, whereas a qSOFA threshold of ≥ 2 demonstrated a comparatively lower sensitivity of 79% and specificity of 74%. Collectively, these findings indicate that the SOS demonstrates superior discriminatory performance over qSOFA in predicting critical care admission and adverse maternal outcomes among patients with pregnancy-associated sepsis, thereby suggesting its preferential utility as a screening and prognostic instrument in this clinically vulnerable population.