Management of a Term Pregnancy Complicated by Severe Impetiginized Atopic Eruption and Oligohydramnios: A Case Report

Background: The management of term pregnancy complicated by active maternal skin infection at the surgical site, bacterial colonization, and fetal anomalies presents a significant therapeutic challenge. Incising through infected tissue for a cesarean section increases the risk of surgical site infection and wound dehiscence. This report analyzes the management of a high-risk pregnancy complicated by secondarily infected Atopic Eruption of Pregnancy (AEP), Group B Streptococcus (GBS) colonization, and oligohydramnios. Case Presentation: A 30-year-old primigravida at 39 weeks and 4 days of gestation presented to a tertiary care center with severe, exudative abdominal dermatitis suggestive of secondary Staphylococcus aureus superinfection and recto-vaginal GBS colonization. Obstetric assessment revealed oligohydramnios (Maximum Vertical Pocket 1.8 cm), an estimated fetal weight of 3950g, and a prenatal diagnosis of cleft lip and palate. To avoid surgical incision through the infected abdominal wall, labor was induced using a Foley catheter. The patient achieved a successful vaginal delivery of a male infant weighing 3900g, with Apgar scores of 6 and 8 at 1 and 5 minutes, respectively. Postpartum management included intravenous Cefotaxime and topical corticosteroids. Conclusion: Vaginal delivery via mechanical induction is a viable strategy to mitigate surgical risks in patients with extensive abdominal skin infection and borderline macrosomia. A multidisciplinary approach utilizing broad-spectrum antibiotics and dermatological therapy resulted in favorable maternal and neonatal outcomes.