[Listeriosis in obstetrical environment. Report on 10-year experience in a maternity hospital in Paris].

Thirty six cases of listeriosis were seen in the hospital between 1975 and 1984. Ten aborted before the 28th week of pregnancy while 26 passed the 28th week of pregnancy. The incidence was about 1 per 1,000 deliveries. The bacteriological diagnosis depends on isolating the germ either from blood cultures or from multiple swabs from the child at birth, or from liquor amnii or from the placenta. The clinical events that occur in pregnancy were analysed in order to trace out the evolution of maternal listeriosis better and to work out from it a good preventive therapeutic approach. Twenty one out of the 26 women found in the month preceding delivery lassitude, often accompanied by a febrile illness which suggested a primary infection with the listeria. The blood cultures from four of them showed L. monocytogenes and treating these ladies with antibiotics enabled the pregnancy to go to term. Thirteen of the infants that were affected developed favourably but 8 died. Four of these died in utero and two (twins) died after being born healthy. The seriousness of the illness in the fetus seems to have a direct relationship to the time between the primary infection and the delivery. Blood cultures make it possible to diagnose the condition at the first sign of infection whatever the clinical features of the case are.