Intrapartum and postpartum pyrexia and infection after induction with extra-amniotic prostaglandin E2 in tylose

One hundred and twenty-four women, bearing 127 children, in whom labour was induced with extra-amniotic prostaglandin E2 in tylose were studied. High vaginal swabs taken from 111 patients immediately before insertion of prostaglandin E2 were examined, specific identification of microbes being restricted to those present in the amniotic fluid, to haemolytic streptococci, and to other specific microbes. Lancefield group B streptococci were isolated from nine patients, and in eight of these the microbes were isolated from the amniotic fluid. Amniotic fluid was examined from 86 patients and was shown to be contaminated with microbes potentially pathogenic for mother or baby in 11 out of 86 (13 per cent) of the patients examined; in eight patients, the contaminating pathogen was the group B streptococcus. All 127 blood cultures taken during or just after delivery were negative. Six out of nine patients with a group B streptococcus in the vagina developed fever and proven streptococcal endometritis; one child developed fever and another streptococcal septicaemia.