Assessment of Sepsis Obstetrics Score for ICU Prediction in Pregnancy Associated Sepsis

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Background: Pregnancy-associated sepsis remains a significant contributor to maternal morbidity and mortality, particularly in low- and middle-income countries. Early recognition is challenging due to physiological changes in pregnancy that overlap with systemic inflammatory response syndrome (SIRS) criteria. The Sepsis Obstetric Score (SOS) has been proposed as a pregnancy-specific tool for early risk stratification. Objectives: To evaluate the effectiveness of the Sepsis Obstetric Score in predicting the need for intensive care unit (ICU) admission among patients with pregnancy-associated sepsis. Materials and Methods: This observational study included 100 obstetric patients (antenatal, postabortal, and postpartum) presenting with suspected sepsis and fulfilling ≥2 SIRS criteria. All patients were assessed using the Sepsis Obstetric Score. Clinical evaluation, laboratory investigations (including complete blood count, band forms, and serum lactate), and organ assessment were performed. A cut-off value of SOS ≥6 was used for analysis. Receiver Operating Characteristic (ROC) curves were constructed to determine predictive accuracy. Results: Out of 100 patients, 64 had SOS ≥6 (Group II) and 36 had SOS <6 (Group I). ICU admission or mechanical ventilation was required in 22% of patients, with a significantly higher proportion in Group II (p=0.003). SOS ≥6 was associated with increased odds of ICU admission (OR = 4.412; 95% CI: 1.615–12.048). The score demonstrated a sensitivity of 80% and specificity of 50% for predicting ICU requirement. The area under the ROC curve was 0.768 (95% CI: 0.669–0.867), indicating good predictive performance. Conclusion: The Sepsis Obstetric Score is a simple and effective tool for early identification of obstetric patients at high risk of requiring intensive care. SOS can aid in triaging and optimizing resource utilization in emergency settings. Further multicentric studies are recommended to validate its widespread clinical applicability.

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