Group B Strep
Most cases (70%) occur in babies born at term. The most common clinical symptom is respiratory distress along with other signs of infection beginning within 24-48 hours of birth. Pneumonia and sepsis (blood infection) are most common but meningitis can also occur. About 2-3% of babies who get sick will die even with prompt treatment.
GBS and this pregnancy
GBS colonization in the mother comes and goes and does not cause any symptoms in the mother. Just because a GBS culture was positive in a previous pregnancy does not mean that it will be positive in a subsequent pregnancy. Negative cultures in previous pregnancies also do not mean that a current pregnancy will be negative. Center for Disease Control guidelines recommend vaginal and rectal cultures for every woman between 35-37 weeks of pregnancy to give an accurate prediction of colonization status at the time of birth. This is by far the best and most accurate predictor of risk. Between 2 and 7% of pregnant women will have GBS in their urine. Even if this is treated during the pregnancy, the baby is 2-4 times more likely to become sick. If your water breaks or you go into labor before test results are available, guidelines recommend treatment only in the presence of risk factors.
The administration of beta-lactam antibiotics (penicillin, ampicillin and cefazolin) during labor is very effective at preventing illness in the baby, reducing infection by 80%. The antibiotics are given through an IV every four hours during labor and are most effective if allowed the full 4 hours to work. Although antibiotic resistance is always a concern, GBS does not appear to be developing any sort of resistance. If a mother is allergic to penicillin, cefazolin is the second choice and clindamycin or vancomycin the third choice. Clindamycin and vancomycin do not get into the fetal circulation as well and GBS is often resistant to clindamycin. (If you are allergic to penicillin, your GBS culture will be specifically tested for resistance to clindamycin.) We are able to administer these antibiotics at the birth location of your choosing in line with current guidelines.
The World Health Organization has extensively tested non-antibiotic methods for reducing GBS infections. One method is a chlorhexidine vaginal wash done during labor. Although it is more effective at preventing illness than doing nothing, it is not nearly as effective as the CDC recommended antibiotic regimens. If you do not wish to receive preventive antibiotics during labor, you will need to sign a waiver stating that you understand the risks of illness.
There is some evidence that GBS colonization comes from an imbalance of the normal vaginal bacteria. In theory, then, taking active probiotics throughout the pregnancy should decrease the number of GBS positive cultures. The potential benefits could be significant if it works and the possible harms from taking a probiotic supplement in a healthy adult are very small. The benefits are not proven at all, but there is currently ongoing research in this area.
Contact Us Today: