Group A Streptococcal Infection During Pregnancy and the Postpartum Period.

Group A Streptococcus, the causative organism for "childbed fever," continues to pose a threat to women during pregnancy and the postpartum period, despite advances in hygiene and the development of antibiotic therapy. This resilient bacterium has resurfaced with intensified virulence, and, for reasons not entirely clear, causes severe disease in some women. Sepsis and toxic shock syndrome caused by Group A Streptococcus contribute to the alarming rates of maternal morbidity and mortality in the United States. Early recognition of the subtle signs and symptoms of sepsis is critical to decrease the risk for mortality; however, early signs can be elusive during the perinatal period because of the physiologic changes of pregnancy. Care management requires a coordinated, collaborative, multidisciplinary team approach. Sepsis is a clinical emergency, and health care providers need to respond as a well-prepared team.