Specific Problems in Perinatal Infections: A Literature Review

Abstract

Although the level of infectious diseases has considerably reduced over time they still remain an important cause of both maternal and perinatal morbidity and mortality. Maternal infections are the fifth leading cause of maternal death and are believed to be the fifth leading cause of death in neonates. Infectious disease is largely preventable and treatable, and as such, reducing the incidence and severity of these infections is a reasonable and achievable goal. Maternal infections range from the relatively innocuous genitourinary tract infections to sepsis and septic shock. Serious infections include those due to Group B streptococci, necrotising enterocolitis and HIV. Group B streptococcal infections can cause several disease states, including pneumonia, sepsis and meningitis in neonates and newborns. With universal application of screening and prophylaxis protocols, this disease can be drastically reduced. Necrotising enterocolitis is a multi-factorial process with an infectious component. While the infectious agents may vary and may not be directly treatable, there are some methods of prevention. Perinatal HIV infection rates have been shown to decrease dramatically with the administration of AZT and nevirapine. Given the fact that the nevirapine protocol is easy to administer, can be initiated at the onset of labour to the mother and from 48–72h post partum to the infant, is less expensive and is quite effective, initiation of this as the standard of care world-wide should greatly reduce the incidence of perinatal transmission of HIV.