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Intrauterine infections with group B beta-haemolytic streptococci
Insights
Group B Streptococcus intrauterine infections caused stillbirth or early death in 15 neonates. Routine bacteriologic studies are crucial for perinatal deaths, even with intact membranes.
Area of Science:
- Neonatal infections
- Perinatal pathology
- Bacteriology
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal infections.
- Intrauterine infections pose a severe risk to newborns.
Purpose of the Study:
- To investigate the characteristics and outcomes of intrauterine GBS infections in neonates.
- To emphasize the diagnostic importance of bacteriologic studies in perinatal deaths.
Main Methods:
- Retrospective case series analysis of 15 infants with intrauterine GBS infections.
- Review of clinical records, placental examinations, and infant autopsy findings.
Main Results:
- All 15 infants experienced stillbirth or died within 6 hours of birth.
- All infants were preterm (<28 weeks gestation, <1000g).
- Placental pathology (chorioamnionitis, funisitis) and infant pneumonitis were common; meningitis and otitis media were also observed.
Conclusions:
- Intrauterine GBS infection is a devastating condition with high mortality in preterm infants.
- Intact membranes at delivery do not rule out intrauterine GBS infection.
- Routine bacteriologic studies are essential for all perinatal deaths to ensure accurate diagnosis and management.
Abstract:
The case records of 15 infants with intrauterine infections due to group B beta-haemolytic streptococci were traced from the records of two geographically separate centres over a 4-year period (1979-1982). Six infants were stillborn and the other nine died within the first 6 h. All the infants weighed less than 1000 g and were less than 28 weeks gestation. Placental examination in 14 of the 15 infants showed the presence of chorioamnionitis and funisitis. The infants also showed evidence of pneumonitis. Four infants had evidence of otitis media, two had evidence of an early meningitis. A history of antepartum bleeding was present in six infants and abundant retroplacental clot was noted in four of them. The membranes had been ruptured for greater than 24 h in only three infants. In six of the infants the membranes were intact at the time of delivery. A history of intact membranes at the time of delivery does not exclude a diagnosis of an intrauterine infection with this organism, and this series of infants highlights the importance of routine bacteriologic studies of all perinatal deaths.