Complications
Complications and treatment of pregnancy associated GAS infections are
presented in Table 2. Thirteen women (19.6%) developed STSS, of whom 10
delivered vaginally and two by caesarean delivery. One woman underwent a
septic abortion by undergoing dilation and evacuation of the uterine
cavity. In the post-partum group, the infectious prodrome occurred soon
after birth, and the STSS was diagnosed within 48 hours of delivery in
eight of the 13 women (61%), between 2 to 7 days in three, and more
than one week postpartum in the remaining two. Positive genital tract
cultures for GAS infection (from the uterus, cervix, vagina, lochia, or
placenta) were obtained from 11 women (84.6%). Blood cultures were
positive in six women. Organ complications included disseminated
intravascular coagulation (n = 4), acute respiratory distress
syndrome (n = 8), acute liver failure (n = 4), acute renal
injury (n = 2), and respiratory failure necessitating intubation
(n = 4).