Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (11): 89-95.doi: 10.6040/j.issn.1671-7554.0.2023.0823

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Clinical analysis of 9 cases with group A streptococcus infection in obstetrics

SONG Min1, CAO Luquan2, WU Lilong1, WU Shuxia3, LIU Jing1, ZHANG Juan1, LIU Cuiying1   

  1. 1. Department of Obstetrics, Jinan Maternal and Child Care Hospital, Jinan 250001, Shandong, China;
    2. Prenatal Diagnosis Center, Jinan Maternal and Child Care Hospital, Jinan 250001, Shandong, China;
    3. Department of Gynecology and Obstetrics, The Fifth Peoples Hospital of Jinan, Jinan 250001, Shandong, China
  • Published:2023-12-12

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Abstract: Objective Abstract: Objective To analyze the clinical data of pregnancy-associated group A streptococcus(GAS)infection in pregnant women with high risk of perinatal infection, and to explore the prevention and treatment strategies. Methods General data of pregnant women at high risk of perinatal infection treated in Jinan Maternal and Child Health Hospital during Jan. 2018 and Jun. 2022 were collected. The source of disease, clinical characteristics, treatment process, maternal and infant outcomes and follow-up of 9 patients diagnosed with GAS infection were analyzed and the prevention and treatment strategies were discussed. Results A total of 27,518 bacterial cultures were obtained. Of the 4,289 positive bacterial specimens, 15 were GAS positive(9 cases), accounting for 0.055% of the total number of bacterial cultures, including 9 from vaginal secretions, 1 from throat swab, 1 from urine culture, 2 from blood cultures, 1 from endometrium, and 1 from perineal incision secretion. Two cases of prenatal onset occurred in the third trimester, and both of the mother and fetus died. Six out of seven cases of postpartum onset had good maternal and infant outcomes after active treatment except for one with malformative induction. During the follow-up, except for 1 case who had another positive GAS culture due to poor perineal incision healing 8 days after discharge, the other 6 cases had no recurrent infections. The initial symptom was 39 ℃ fever, and the ratio of neutrophils in blood was over 90%. Conclusion GAS infection is closely related to obstetrics, and pregnant and postpartum women are at high risk. Obstetric infection can be divided into two types: prenatal and postpartum. Prenatal infection is relatively severe, resulting in a higher mortality rate. Perinatal GAS infection is an important cause of severe infection and death in pregnant and postpartum women. Screening high-risk populations and early identification and treatment can help improve the maternal and fetal outcomes.

Key words: Group A streptococcus, Streptococcus pyogenes, Toxic shock syndrome, Pregnancy, Puerperium

CLC Number: 

  • R714
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