Evaluation of sepsis in obstetric score: a novel scoring system for obstetric population, a tertiary care centre study

Background: Sepsis remains the second leading cause of maternal mortality, affecting approximately 5.7 per 10,000 pregnancies. Delayed recognition and escalation of care contribute to preventable deaths. The Sepsis in Obstetrics Score (SOS), designed by Albright et al. to predict critical care needs in pregnant and postpartum women, has limited validation data. This study evaluates SOS in predicting maternal and neonatal outcomes in septic obstetric patients. Methods: A prospective study was conducted on 50 pregnant, post-abortal, and postpartum women with sepsis at GSVM Medical College, Kanpur. Patients with pre-existing organ disease were excluded. SOS was calculated using clinical and laboratory parameters, with scores <6 classified as non-severe and ≥6 as severe sepsis. Outcomes assessed included ICU admission, organ dysfunction, maternal and neonatal mortality, and hospital stay. ROC analysis determined the optimal cutoff for predicting mortality. Results: Mortality rose with higher SOS scores: 5.3% (0–2), 18.2% (3–5), 30% (6–8), and 71.4% (9–11). ICU admission and multi-organ failure were significantly more frequent in the ≥6 group. Neonatal outcomes were worse among high-score mothers, with more NICU admissions (5 vs. 1) and stillbirths (9 vs. 6). ROC analysis showed good predictive accuracy (AUROC 0.859, p<0.001). A cutoff ≥5 predicted mortality with 92.3% sensitivity, 62.2% specificity, and 70% diagnostic accuracy, outperforming the traditional ≥6 threshold by identifying high-risk women earlier. Conclusions: SOS is a reliable triage tool for obstetric sepsis. A threshold ≥5 enables earlier ICU transfer, timely intervention, and improved maternal and perinatal outcomes, supporting its integration into routine obstetric care.