title: Fever and pregnancy.
abstract: Severe infections during pregnancy and postpartum are rare, despite a high frequency of bacteraemia, but remain on of the leading cause of maternal death. Therapeutic guidelines validated in general population should be applied to pregnant women, with regards to their specificities: insidious clinical signs and rapid onset, clinical presentation often as respiratory failure due to physiological changes during pregnancy; most frequent causes: pneumonia, pyelonephritis, genitary tract infections; sensibility to virus, Listeria, malaria, due to immunological changes during pregnancy; caesarean section is the single most important risk factor of postpartum infection; aggressive treatment should be started promptly, including fluid infusion and early administration of vasoactive agents (Norepinephrine); broad-spectrum intravenous empirical antibiotic therapy must be established immediately (within the first hour), and chosen according to frequent microorganisms involved in sepsis during pregnancy; infectious source, mostly pelvic, is often accessible to surgery; if foetal extraction does not improve maternal outcomes, it remains necessary for obstetrical or foetal reasons and mandatory if chorioamnionitis is confirmed; specific attention should be drawn to streptococcus A invasive infection which experiments a recent resurgence and is correlated to a high morbidity and mortality for both the mother and the foetus; protocols should be written in every maternity.
authors.affiliation: Département d'anesthésie-réanimation, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France. Electronic address: agnes.le-gouez@aphp.fr.
authors.forename: Agnès
authors.initials: A
authors.lastname: Le Gouez
authors.affiliation: Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benachi
authors.affiliation: Département d'anesthésie-réanimation, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France.
authors.forename: Frédéric J
authors.initials: FJ
authors.lastname: Mercier
mesh_terms: D000328:Adult; D005260:Female; D005334:Fever / Q000628:therapy*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D011256:Pregnancy Outcome; D011645:Puerperal Infection
keywords: Fever; Pregnancy