Group B streptococcus in pregnancy

9 MONTHS PREGNANT | GROUP B STREP POSITIVE | PREPARING FOR LABOR | 36 WEEKS PREGNANT (June 2019).

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What are group B streptococci ?

Group B streptococcus or B-streptococci are one of many types of bacteria that live in the human body. About every third woman has these streptococci without knowing it (Heath and Jardin 2010).

About one-third of all pregnant women also have group B streptococci in their vaginas. Normally these bacteria are completely harmless and most babies born to mothers with group B streptococcus are born completely healthy. Fortunately, it is very rare for the bacteria to cause serious illness in the baby, much less likely to cause the death of a newborn (RCOG 2003, 2007).

How do I know if I carry Group B streptococci?

If you're a carrier of group B streptococci, you probably will not know. Usually the bacteria are completely harmless and do not make you sick.

So if you want to know if you have Group B streptococcus, you'll need to ask your doctor for a test. This is not routinely done unless you belong to a high risk group. Have the test done in the last few weeks before delivery by your gynecologist. The cost of about 20 - 30 € does not take over the cashier.

I have group B streptococci. What now?

If you've ever had a child with B-streptococcal disease, or if the test detects it in your vagina, then it will be added to your mother's passport. As a result, doctors know at birth what to do. You will get antibiotics during birth. To do this, the doctor will place a cannula in the arm vein once the amniotic sac bursts or contracts labor, whichever comes first, until your baby is born (GBSS 2007a, RCOG 2003, 2007). Your baby will be examined directly for an infection after birth.

Talk to your gynecologist and develop a birth plan to protect your child from the infection. In the vast majority of cases, the medical profession succeeds in getting your baby safe, healthy and free of infections. But you will not be able to give birth in a birth house, but only in the clinic.

What must I know about group B streptococci for my pregnancy?

Most babies who come into contact with group B streptococci before or during labor remain perfectly healthy and well.

Unfortunately, about one in 2,000 babies develop streptococcal infection immediately after birth (Heath and Jardin 2010, HPA 2010, RCOG 2003, 2007). Fortunately, a baby dies very rarely (Heath and Jardin 2010, RCOG 2003, 2007).

The greatest risk of infection exists during childbirth. But caesarean section is only helpful if it has been planned and made before labor or when the bubble is broken. Then you do not need antibiotics during childbirth.

If, however, your doctor decides that you need a so-called emergency cesarean section only during the birth, then the bacteria can be transferred to your baby despite the cesarean section (GBSS 2007a). Therefore, you will then get antibiotics and your baby will be examined for streptococci.

It can happen that you get a uterine infection or urinary tract infection from group B streptococci.

What is the risk for my baby to get a streptococcal infection?

There are a number of factors that tell you something about the likelihood. The risk of infection increases when (Heath and Jardin 2010, Ohlsson and Shah 2010, RCOG 2003: 3-6):

  • you get a premature labor (before pregnancy week 37)
  • when your amniotic sac bursts but until birth
  • you have elevated temperature or fever during labor
  • In your current pregnancy group B streptococcus have been detected in the urine or vagina
  • you have a child that has a streptococcus at birth Infection had

How can I protect my child from infection at birth?

If you do not belong to any of the above risk groups, then it is very unlikely that your baby will develop a streptococcal infection.

If you belong to the risk group, then the intravenously administered antibiotics will prevent an infection. Ideally, the treatment begins four hours before your baby is born (DGGG 2010, 3. 2. 3.).

A pediatrician will decide immediately after delivery if your child needs further help:

  • If you have been treated during the birth and you and your baby are healthy, no further antibiotics will be given
  • If you have not been treated during the birth, but you and your baby are perfectly healthy, your baby will be monitored for 48 hours and possibly undergo a laboratory examination.
  • If you and / or your child have the first signs of infection, then your baby will be prompt treated with antibiotics (via a vein)

What symptoms would my baby have with a streptococcal infection?

Group B streptococcal infections usually show up within a week of birth. 90 percent of them occur within the first 24 hours (Heath and Jardin 2010, RCOG 2003: 7-8).

The doctors will identify typical signs immediately after birth or after a short time. Your baby would:

  • grunt
  • bad and drink little
  • be lethargic
  • be cranky
  • have low blood pressure
  • have an unusually high or low temperature
  • an unusual heart and / or or respiratory rate (Heath and Jardin 2010, GBSS 2007b).

Group B streptococcal infection may not occur until the second week of life. Less common are one-month infections and are virtually impossible once your baby is three months old (Ohlsson and Shah 2010).

Group B streptococci can cause bacterial meningitis (Heath and Jardin 2010). The later the infection occurs, the less problematic the infections are. Most babies respond well to treatment, but meningitis can also cause lasting health problems (Heath and Jardin 2010).

Talk to your doctor / midwife if you are worried or have any of the symptoms of an infection in your baby. Even if it's just a false alarm, it will calm you down and that's the most important thing.

Sources

Brocklehurst P, Kenyon S. 2008. Evaluation of Antenatal Screening for Group B Streptococcal (GBS) carriage against NSC Handbook Criteria. UK National Screening Committee. www. screening. nhs. uk [as of March 2012]

DGGG. German Society for Gynecology and Obstetrics e. V., Guideline 3. 2. 3 Prophylaxis of Neonatal Sepsis by Group B Streptococci, // www. AWMF. org [as of May 2013]

GBSS. 2007a. What is Group B Streptococcus: FAQs. Group B Strep Support. www. gbss. org. uk [as of March 2012]

GBSS. 2007b. GBS infection in babies. Group B Strep Support. www. gbss. org. uk [as of March 2012]

Heath P, Jardine L. 2010. Neonatal infections: group B streptococcus. Clinical Evidence . On-line.

HPA. 2010. Infection reports: Pyogenic and non-pyogenic streptococcal bacteraemia, England, Wales and Northern Ireland: 2009 . www. hpa. org. uk [Accessed Janaury 2012]

NCCWCH. 2008a. Antenatal care: routine care for the healthy pregnant woman . National Collaborating Center for Women's and Children's Health, Clinical Guideline. London: NICE. www. nice. org. uk [pdf file, as of March 2012]

NCCWCH. 2008b. Intrapartum care: Care of healthy women and their babies during childbirth. National Collaborating Center for Women's and Children's Health. Clinical Guideline. London: NICE. www. nice. org. uk [pdf file, as of March 2012]

Ohlsson A, Shah VS. 2009. Intrapartum antibiotics for known maternal group B streptococcal colonization. Cochrane Database of Systematic Reviews (3): CD007467.

RCOG. 2003. Prevention of early onset neonatal group B streptococcal disease. Royal College of Obstetricians and Gynecologists, Green Top Guideline no.36. London: RCOG press. www. rcog. org. uk [pdf file, as of March 2012]

RCOG. 2007. Preventing group B streptococcus (GBS) infection in newborn babies - information for you. Royal College of Obstetricians and Gynecologists. London: RCOG press. [As of March 2012]

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