Schöls W A, Hoogendoorn G A, Scholten P C, van Kregten E, Visser G H
Afd. Verloskunde en Gynaecologie, Høfpoort Ziekenhuis, Woerden.
Ned Tijdschr Geneeskd. 1997 Sep 27;141(39):1841-5.
Two previously healthy women, aged 30 and 35 years, suffered pain in the lower abdomen, one before and the other after spontaneous delivery at 40 and 33 4/7 weeks of amenorrhoea, respectively, while a third woman, aged 33, at 36 weeks of amenorrhoea developed pain in the lower abdomen, fever, vomiting, and diarrhoea. All three women were found to have a uterine infection caused by streptococci of Lancefield group A (group A Streptococcus, GAS). In one woman, the diagnosis was made rapidly so that antibiotic treatment could be instituted in time; the other two developed sepsis and multiorgan failure, with a fatal issue in one of them. The three children also were septic, two recovered after treatment and one died. Since the eighties, serious GAS infection has been on the increase. The worst manifestation is the toxic shock syndrome caused by streptococci. Abdominal pains after delivery may be a first sign of this, and should not too readily be interpreted as just after pains. The condition may also develop before delivery. In view of the high mortality rate, early diagnosis and antibiotic treatment are of vital importance for mother and child.
两名此前身体健康的女性，年龄分别为30岁和35岁，分别在停经40周和33又4/7周自然分娩前和产后出现下腹部疼痛，而第三名33岁女性在停经36周时出现下腹部疼痛、发热、呕吐和腹泻。所有三名女性均被发现患有由A群链球菌（A组链球菌，GAS）引起的子宫感染。其中一名女性诊断迅速，得以及时进行抗生素治疗；另外两名女性发展为败血症和多器官功能衰竭，其中一人死亡。这三名儿童也发生了败血症，两名经治疗后康复，一名死亡。自80年代以来，严重的GAS感染一直在增加。最严重的表现是由链球菌引起的中毒性休克综合征。分娩后的腹痛可能是其首要迹象，不应轻易将其仅仅解释为产后宫缩痛。这种情况也可能在分娩前发生。鉴于高死亡率，早期诊断和抗生素治疗对母婴至关重要。
