ABSTRACT
Puerperal sepsis, formerly known as ‘childbed fever’, was responsible for around twothirds of deaths of women in the eighteenth and nineteenth centuries. Handwashing, aseptic techniques, improved general health and antibiotic treatment all contributed to a dramatic improvement in safety for mothers during childbirth (Lucas et al. 2012), although in resource-poor settings, poverty and health inequality continue to contribute to maternal deaths from infection (Acosta & Knight 2013). However, in the UK, the rate of maternal mortality from sepsis has doubled in the last 20 years (Acosta et al. 2012), and the report of the Confi dential Enquiries into Maternal Deaths (CEMD) in the United Kingdom for 2006-08 stated that sepsis had become the leading direct cause of maternal deaths (CMACE 2011). Deaths occurred during pregnancy as well as in the postnatal period. A virulent organism, Lancefi eld group A beta-haemolytic streptococcus (GAS) was responsible for nearly half of the deaths (13 out of 29) (CMACE 2011). Figures for maternal death refl ect a much larger incidence of morbidity.
