THE WOMEN’S HEALTH GROUP, P.C.

9195 Grant Street, Suite 410, Thornton, CO 80229

Phone: 303-280-2229 (BABY)

300 Exempla Circle, Suite 470, Lafayette, CO 80026

Phone: 303-665-6016

www.whg-pc.com

GROUP B STREP TESTING IN PREGNANCY

What is Group B Strep?

Group B Streptococcus (or GBS) is one of the many bacteria that live in the body and usually do not cause serious illness. It is found in the digestive, urinary, and reproductive tracts of men and women. In women, it can be found in the vagina and rectum. GBS is not a sexually transmitted disease. Also, although the names are similar, GBS is different from group A streptococcus, the bacteria that causes “strep throat.”

A person who has the bacteria but shows no symptoms is said to be “colonized”. The number of bacteria that a person has may change over time. A person colonized with a large number of bacteria may have low levels of bacteria months or years later. It also is possible for the number of bacteria to decrease to levels that cannot be detected.

Most pregnant women who are colonized with GBS have no symptoms or health effects. A small number may develop a urinary tract infection or infection of the uterus caused by GBS. The most serious health effect is that a woman colonized with GBS late in her pregnancy can pass it to her baby. For this reason, women are tested for GBS late in pregnancy. If GBS is present, a woman will receive treatment during labor.

How does a baby acquire GBS infection?

There are two types of GBS infections in newborns. Both types of infections can be serious. About 5% of babies infected with GBS will die.

1. Early-onset infections—Early-onset infections occur during the first week of life, generally within the first 24–48 hours after birth. These infections can occur as the baby moves through the birth canal of a woman who is colonized with GBS. Only a few babies who are exposed to GBS develop an infection. Certain factors, such as preterm birth, may increase the risk of a baby becoming infected. The most common problems caused by early-onset GBS infections are lung infections, blood infections, and meningitis.

2. Late-onset infections—These infections occur after the first 6 days of life. Late-onset infections may be passed from the mother to the baby during birth or they may be caused by contact with other people who are colonized with GBS. Late-onset infection can lead to meningitis and other diseases, such as pneumonia. GBS testing late in pregnancy and treatment during labor can help prevent early-onset infections. However, it does not prevent late-onset infections. Late-onset GBS infection most commonly causes meningitis. In newborns, the signs and symptoms of meningitis can be hard to spot. If your baby has any of the following signs or symptoms, contact your pediatrician right away:

·         Slowness or inactivity

·         Irritability

·         Poor feeding

·         Vomiting

·         High fever

How can GBS infection of the newborn be prevented?

To help prevent early-onset GBS infection, women are tested for GBS late in pregnancy, between weeks 35 and 37. The test is called a culture. In this test, a swab is used to take a sample from the woman’s vagina and rectum. This procedure is quick and is not painful. The sample is sent to a lab where it is grown in a special substance. It may take up to 2 days to get the results.

If results of the culture test are positive, showing that GBS is present, you most likely will receive treatment with antibiotics during labor to help prevent GBS from being passed to your baby. Antibiotics help get rid of some of the bacteria that can harm the baby during birth. The antibiotics work only if they are given during labor. If treatment is given earlier in pregnancy, the bacteria may regrow and be present during labor.

Penicillin is the antibiotic that is most often given to prevent early-onset GBS infection in newborns. If you are allergic to penicillin, tell your health care provider before you are tested for GBS. Women with mild allergic reactions can take an antibiotic called cefazolin. If you have had a severe reaction to penicillin, such as hives or anaphylaxis, the bacteria in the sample need to be tested to determine the choice of antibiotic.

Even if you had a negative GBS test result in a previous pregnancy, you still need to be tested during each pregnancy. If you had a positive GBS test result in a prior pregnancy, you need to be tested again during each pregnancy. You may no longer have the bacteria.

If you had a previous baby with GBS infection or if your urine has GBS bacteria during this pregnancy, you are at high risk of passing GBS on to your baby during labor and delivery. You will receive treatment during labor to protect your baby from infection. You will not need to be tested between weeks 35 and 37 of pregnancy.

Do You Need Treatment for GBS during Labor and Delivery?

You WILL need treatment for GBS during labor and delivery if you have any of the following:

·         A previous baby with GBS infection

·         GBS is found in the urine during this pregnancy

·         A positive culture test result during this pregnancy

·         If your GBS status is not known (you did not have a GBS culture test during this pregnancy, the test was not complete, or the results are not known) and any of the following occur you will need treatment during labor and delivery:

o    You go into labor at less than 37 weeks of pregnancy

o    Your water breaks 18 hours or more before delivery

o    You have a fever during labor

You WILL NOT need treatment for GBS during labor and delivery if you have the following:

·         A planned cesarean delivery, and it is done before your labor starts or water breaks even if you are GBS positive

·         A negative result from a GBS test done between weeks 35 and 37 of this pregnancy