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Group B streptococcus amnionitis with intact membranes associated with quintuplet delivery
Summary
Chorioamnionitis, often causing premature birth, can be caused by Group B Streptococcus (GBS). This case highlights GBS infection with intact membranes, leading to neonatal sepsis but with a positive survival outcome.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Chorioamnionitis is a significant cause of preterm labor and delivery.
- Group B Streptococcus (GBS) is a prevalent pathogen in neonatal sepsis.
- Neonatal mortality is a serious concern associated with chorioamnionitis.
Observation:
- A rare case of chorioamnionitis with intact membranes and amniotic fluid infected by GBS is presented.
- Premature labor occurred despite intact membranes and the presence of cervical mucus.
- All five infants born to the mother were contaminated with GBS.
Findings:
- The amniotic fluid was infected with GBS, despite intact membranes.
- All neonates were contaminated with GBS, indicating vertical transmission.
- All affected infants survived, suggesting potential for positive outcomes even in severe GBS cases.
Implications:
- This case prompts re-evaluation of antepartum steroid use in the context of intact membrane chorioamnionitis.
- Obstetricians should consider GBS screening and prophylactic measures in preterm labor, even with intact membranes.
- Vigilant monitoring, including weekly vaginal cultures and antimicrobial treatment, is crucial for managing imminent preterm delivery at risk for chorioamnionitis.