1. THINK SEPSIS Lessons from the Confidential Enquiries 2009-12

2. Classification

3. Characteristics of Women who Died

4. Characteristics of women who survived septic shock

5. Comparison between women who died and women who survived

6. Themes

7. Theme: Delay in Diagnosis

8. Theme: Delay in Diagnosis

9. Theme: Incomplete Assessment

10. Theme: Incomplete Assessment

11. Themes Postnatal Delay in Diagnosis & Incomplete Assessment

12. Theme: Immediate treatment

13. Theme: Immediate treatment

14. Antibiotics

15. Lactate

16. Fluid Resuscitation

17. Theme: Assessment & Monitoring

18. Theme: Assessment and Monitoring

19. Theme: Care setting

20. Theme: Communication

21. Theme: Communication

22. Theme: Communication

23. Theme: Governance

24. Summary