Abstract
Underwater delivery is one of the most popular of the various delivery methods currently available among parturient women in Japan. However, this method carries several risk factors for infection that can affect both the mother and child: influx of bathtub water contaminated with opportunistic bacteria into the vagina and uterus, as well as laceration of the vagina after giving birth, may affect the mother, and bacterial infection by opportunistic bacteria present in the bathtub water at the time of birth may affect the neonate. The present study investigated the safety of underwater delivery from the bacteriological perspective. Samples of bathtub water before and after delivery, and the oral fluid of newborns were collected from 7 cases of underwater delivery during 2004 from a maternity center in Tokyo that agreed to participate in this study. Total bacterial and coliform bacteria counts were determined, and the presence of Staphylococcus spp., Escherichia coli, and Pseudomonas spp. was determined in each sample. The total bacterial count had increased in the bathtub water after delivery in all but one case. The total bacterial count in the oral fluid of the newborns was higher in the underwater delivery group than in the labor relaxation group. Staphylococcus aureus, E. coli, and Pseudomonas putida were detected in the bathtub water after delivery in some cases. In particular, P. putida was isolated from the oral fluid of one newborn and from three samples of the bathtub water after delivery. The similarity values of the SpeI-PFGE profiles of these P. putida isolates were over 90%, suggesting that there was a common contamination source. Although the survey was small and discontinuous, this study suggests that there is a risk of infection during underwater delivery for both mothers and infants via the bathtub water, and that the risk of infection depends on their health status, as well as the presence of birth canal lacerations and incomplete uterine cervical atresia.
