According to Dr. Brenna Anderson, we have Austrian Obstetrician Ignaz Semmelweiss to thank for the practice of handwashing in obstetric clinics. Semmelweiss implemented the practice in his clinic in 1847 and quickly noticed a dramatic decline in the number of women who were dying from infections related to childbirth. Semmelweiss saw a drop from 10% to 2% and although hand washing is considered standard procedure today, women can still contract life-threatening infections during pregnancy and childbirth.

Strep and pregnancy

Of particular concern to Anderson is Group A streptococcus (GAS), the same bacteria that causes strep throat. When strep infection occurs in the uterus, complications quickly set in and the death rate soars to as high as 50%.

Complications related to GAS infection include endometritis, necrotizing fasciitis (more famously referred to as flesh-eating bacterial infection), and streptococcal toxic shock syndrome. Any of these complications can lead to sepsis, an illness that affects the entire body and is often fatal. On a global scale, sepsis kills millions of people every year.

Anderson, Associate Professor of Obstetrics and Gynecology at the Warren Alpert Medical School of Brown University and Director of the Women’s Infectious Diseases Consultative Service at Women & Infants of Rhode Island, recommends an aggressive approach to diagnosis and treatment of GAS infection in pregnant and postpartum women.

Symptoms of strep

Symptoms of GAS during pregnancy don’t match the textbook list of symptoms doctors may be more familiar with. Lack of awareness of pregnancy-specific symptoms can delay diagnosis and treatment while the infection continues to develop.

During pregnancy, GAS symptoms can include extremes of temperature, pain that is vague and unusual, and pain in the extremities. These symptoms might be misdiagnosed as something other than GAS. The infection is also rare and unusual, characteristics that might also delay diagnosis and immediate life-saving treatment.

Rapid treatment required

Anderson says screening measures that involve imaging technologies may not indicate a problem, which causes treatment to be dangerously delayed. Her recommendation is that a uterine tissue sample is tested any time a GAS infection is suspected in a pregnant woman or one who has recently given birth. She suggests that the small tissue sample and blood culture would reveal signs of infection more reliably and more rapidly than other diagnostic methods.

“When suspected, invasive GAS infections need to be treated quickly,” according to Anderson. A very specific course of antibiotics may cure the infection but, in extreme or unresponsive cases, surgery may be required to save a patient’s life.