Sriskandan S
National Centre for Infection Prevention and Management, Department of Infectious Diseases & Immunity, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK.
J R Coll Physicians Edinb. 2011 Dec;41(4):339-46. doi: 10.4997/JRCPE.2011.411.
Despite global efforts to reduce maternal mortality, maternal deaths from bacterial sepsis have actually risen in the UK. The group A streptococcus, also known as Streptococcus pyogenes, is the leading cause of infection-related death in pregnancy and the puerperium. Many clinicians remain unaware of the risks posed to this particular group of otherwise fit, healthy patients despite the fact that S. pyogenes has been the leading infective cause of puerperal deaths since records began. S. pyogenes has a specific but unexplained predilection for the recently pregnant woman, and has an attributable mortality greater than many other invasive bacteria. Here, the epidemiology, aetiology, and management of severe peripartum sepsis are discussed, as are potential approaches to reduce risks. While fundamental changes in healthcare access can lead to dramatic reductions in maternal deaths in developing countries, an improvement in maternal sepsis deaths in the UK will require heightened awareness among both hospital and community-based clinical staff.
尽管全球都在努力降低孕产妇死亡率，但在英国，因细菌性败血症导致的孕产妇死亡人数实际上却有所上升。A 组链球菌，也称为化脓性链球菌，是妊娠和产褥期感染相关死亡的主要原因。尽管自记录开始以来，化脓性链球菌一直是产褥期死亡的主要感染原因，但许多临床医生仍然没有意识到这种特殊情况会给这群原本健康的患者带来风险。化脓性链球菌对近期怀孕的女性有特定但无法解释的偏好，其可归因死亡率高于许多其他侵袭性细菌。本文讨论了严重围产期败血症的流行病学、病因学和管理方法，以及降低风险的潜在途径。虽然医疗保健可及性的根本变化能够大幅降低发展中国家的孕产妇死亡人数，但要降低英国孕产妇败血症的死亡人数，就需要提高医院和社区临床工作人员的认识。
