Background: Sepsis during and following pregnancy remains an important cause of maternal death globally, accounting for 11% of all maternal death, it can progress rapidly and cause multi-organ failure if not recognized and treated promptly. Early identification and timely antibiotics significantly improve outcomes for both mother and baby.

Aim: To evaluate the recognition and management of intrapartum sepsis in accordance with the national guidelines. To assess compliance with the sepsis six bundle.

Standards: RCOG No.64, NICE NG51, local guideline.

Method: A retrospective clinical audit that involves the women in active labour who was diagnosed with sepsis and the sepsis pathway was activated for them, it covered the period from 01/09/2024 to 31/08/2025. The data was collected from electronic medical records using a standardized data collection proforma and compared against RCOG and NICE standards.

Results: the audit involved 21 women where the sepsis pathway was activated to them, 28.57% of the patient only met the criteria of the sepsis, 71.43% of the patient were not meeting the criteria for the sepsis and the only indicator to start the sepsis was a high temperature. Compliance with early sepsis management was high, with 100% of patients receiving antibiotics within one hour. Intravenous fluid administration and serum lactate measurement were achieved in 90% of cases. Urine output monitoring was documented in 76.19%, and no patients required supplemental oxygen.

Conclusion: this audit demonstrated good compliance with most of the sepsis bundles including antibiotics, I.V fluid and serum lactate but identified deficiencies in recognition of the sepsis and monitoring the urine output. Recommendations include staff education to differentiate between the physiological changes during labour and sepsis and update the local guideline in view of the new update in RCOG maternal sepsis guideline. A re-audit is planned to assess improvement.

Fatimah Al-Rufaye has completed her medical school in 2015 from Baghdad university, Iraq. she moved to the UK in 2022 after getting her GMC registration, she is working in Dorset County Hospital for the last 2 years in obstetrics and gynaecology department.