{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:41:08Z","timestamp":1788493268463,"version":"build-2803163510"},"reference-count":44,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016286","name":"HRP Alliance for Research Capacity Strengthening","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100016286","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000855","name":"University of Birmingham","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100000855","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR300808"],"award-info":[{"award-number":["NIHR300808"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007607","name":"University Research Council, Aga Khan University","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100007607","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000836","name":"University of Liverpool","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100000836","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,6,29]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Maternal sepsis is the third leading cause of maternal mortality globally. WHO and collaborators developed a care bundle called FAST-M (\n                      <jats:italic>F<\/jats:italic>\n                      luids,\n                      <jats:italic>A<\/jats:italic>\n                      ntibiotics,\n                      <jats:italic>S<\/jats:italic>\n                      ource identification and treatment,\n                      <jats:italic>T<\/jats:italic>\n                      ransfer and\n                      <jats:italic>M<\/jats:italic>\n                      onitoring) for early identification and management of maternal sepsis in low-resource settings. This study aimed to determine feasibility of FAST-M intervention in a low-resource setting in Pakistan. The FAST-M intervention consists of maternal sepsis screening tools, treatment bundle and implementation programme.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>A feasibility study with before and after design was conducted in women with suspected maternal sepsis admitted at the Liaquat University of Medical and Health Sciences hospital Hyderabad. The study outcomes were compared between baseline and intervention phases. In the baseline phase (2 months), the existing sepsis care practices were recorded, followed by a training programme for healthcare providers on the application of FAST-M tools. These tools were implemented in the intervention phase (4 months) to assess any change in clinical practices compared with the baseline phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the FAST-M implementation, 439\u2009women were included in the study. 242\/439 were suspected maternal infection cases, and 138\/242 were women with suspected maternal sepsis. The FAST-M bundle was implemented in women with suspected maternal sepsis. Following the FAST-M intervention, significant changes were observed. Improvements were seen in the monitoring of oxygen saturation measurements (25.5% vs 100%; difference: 74%; 95%\u2009CI: 68.4% to 80.5%;\u2009p&lt;0.01), fetal heart rate assessment (58% vs 100%; difference: 42.0%; 95% CI: 33.7% to 50.3%; p\u22640.01) and measurement of urine output (76.5% vs 100%; difference: 23.5%; 95% CI: 17.6% to 29.4%; p&lt;0.01). Women with suspected maternal sepsis received all components of the treatment bundle within 1\u2009hour of sepsis recognition (0% vs 70.5%; difference: 70.5%; 95% CI: 60.4% to 80.6%; p&lt;0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of the FAST-M intervention was considered feasible and enhanced early identification and management of maternal sepsis at the study site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN17105658\">ISRCTN17105658<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-069135","type":"journal-article","created":{"date-parts":[[2023,7,30]],"date-time":"2023-07-30T23:00:11Z","timestamp":1690758011000},"page":"e069135","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Early recognition and management of maternal sepsis in Pakistan: a feasibility study of the implementation of FAST-M intervention"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"isrctn17105658","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8391-8559","authenticated-orcid":false,"given":"Sheikh Irfan","family":"Ahmed","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghulam Kubra","family":"Rind","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheel","family":"Sikandar","sequence":"additional","affiliation":[{"name":"OBGYN, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Raza","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bakhtawar M Hanif","family":"Khowaja","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, The Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahmida","family":"Parveen","sequence":"additional","affiliation":[{"name":"OBGYN, Liaquat University of Medical and Health Sciences, Jamshoro, 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