Th e clinical manifestations of sepsis include the hallmarks of systemic infl ammation that may be followed by coagulopathy, vasoplegia, and evolving multiple organ failure. Th e patient typically has a temperature of 38°C during the period from the end of the fi rst to the end of the 10th day after childbirth or abortion. Purpura fulminans may be associated with GAS infection. Physicians must have a high index of suspicion for sepsis in any peripartum patient who presents with fever and evidence of organ dysfunction: confusion, oliguria, tachycardia, and so on. Treatment includes fl uid resuscitation, empiric antibiotic therapy, and source control. Early aggressive volume resuscitation is essential and is followed with vasopressor therapy if necessary. Th ere is no evidence to suggest that norepinephrine has an adverse eff ect on fetal well-being. Th ere are no data on the use of vasopressin during pregnancy. Considering current data and the specifi c exclusion of pregnant (but not postpartum) patients from the PROWESS (Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis) trial and other trials, we cannot recommend the use of activated protein C during pregnancy. However, this agent may be of value in the postpartum period and clinicians should weigh up its value as a potent anti-infl ammatory/anticoagulant agent versus the risk of bleeding complications.