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Semmelweis: the combat against puerperal fever
A H Adriaanse1, M Pel, O P Bleker
1Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, The Netherlands.
Insights
Group A streptococci historically caused puerperal fever, while Group B streptococci pose risks to newborns today. Modern obstetrics focuses on cost-effective preventive measures during labor to combat neonatal infections.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Neonatal Health
Background:
- Group A streptococci historically posed a significant threat, causing puerperal fever, particularly during the 19th century's shift to hospital births.
- Pioneering figures like Semmelweis faced resistance despite evidence-based findings, impacting patient outcomes.
- Group A streptococci remain a rare cause of puerperal sepsis, while Group B streptococci are prevalent and can lead to severe neonatal morbidity or mortality.
Abstract:
Groups A and B streptococci are of great significance in the history of obstetrics. Group A streptococci were a great threat to the puerperium, especially in the 19th century, when homebirth was replaced by institutional birth in lying-in hospitals. The history of the rise and fall of puerperal fever is indeed a tragedy. Some people, like Semmelweis, who brought new and important evidence based findings were not believed by their fellow obstetricians, an attitude that spoiled thousands of innocent lives. Even today group A streptococci, though seldom, may be the cause of puerperal sepsis. Group B streptococci are widespread and may cause sepsis and important lifelong morbidity or mortality of the newborn. Obstetricians today try to establish cost-effective prophylactic measures during labor to prevent these neonatal infections.