Perinatal infections: the obstetrician's viewpoint.

The obstetrician's role is to recognize and treat maternal systemic infections which may spread transplacentally to the fetus, and to ensure that the lower genital tract is kept free from pathogenic organisms, particularly during the last trimester of pregnancy. In some cases the obstetrician can reduce the likelihood of premature rupture of the membranes by inserting a cervical suture. Where this has not been possible conservative management should be used to keep the fetus in utero before the 34th week and more active after this time. In trapartum infections can be reduced to a minimum by keeping the membranes intact during early labour, by the aggressive use of uterine stimulants to avoid prolonged labour, by exerting extreme care to avoid sepsis during pelvic examinations and internal monitoring, and by earlier use of Caesarean section.