Strep B - totally confused!!

[beepbeep]

I found out I was +ve for Strep B when the results of a swab came back 5 das after the birth of my son, I had had a very quick labour (3hrs), water birth and waters went just before he was born. He was v healthy.

I am ow pregnat agan (DS is 13m) and duein Nov, I have been tested again and this time it's come back -ve, though I am aware the strep B comes and goes. I was told by consultant that I would need 2 lots of antiobiotics, 4 hours apart in labour due to Step B in previous pregnancy. On advising him that both my labours had been less than 4 hours each he decided one course would be ok and they wouldn't give th other direct to the baby. This totally confused me as it totally contradicted all I had read.

I now read on the NHS website that if you had a baby whilst carrying GBS and it developed the infection, then you should have antibiotics next time, but if you just carried it and the baby did not contract the infection then antibiotics are not recommended - WTF??!! So why is my consultant saying that I should have them?! I did query not having them and he told me he would not advise this as the infection is a lot easier to prevent than treat and scared me with stries of meningitus (sp?). I'm thinking about asking to see another consultant, what should I do? (it's been left that when I go into labour I go stright to hospital and they give me one lot of antibiotics and obviously if i'm in labour long enough they'll give me the second)

Advise please . . . .!!

[moaningminniewhingesagain]

this is very helpful

You are right, current recommendations are to offer antibiotics if previously affected(ie ill) baby, or other risks factors like waters being broken for a long time, fever in labour, or strep b being present in the urine.

If you especially want antibiotics then fine, but in this situation, personally I wouldn't, as they have their own problems.

Homebirth.org.uk also has good info, whether you are considering homebirth or not, and of course site
hth

BTW, I had strep b in first labour (didn't know til a year later when I got my notes), I refused antibiotics for prolonged ruptured membranes, and all was well. If had known, given the risk factor, I probably would have accepted. But I wouldn't have had them just in case, I chose not to test in 2nd pregnancy.

[Verity79]

I tested +ive for GBS at 24 weeks (was swabbed for thrush). I will be retesting privately at 36 weeks after using garlic as outlined in this article. I will also be using Hibiscrub surgical cleanser as an external wash to try and prevent cross infection. You may wish to try something similar or just get retested for your peace of mind.

I am going to be having a homebirth with no antibiotics UNLESS I have a fever during labour, my waters breaking for 12 hours and no sign of baby coming, fetal distress or labour before 37 weeks. If any of those happen I will transfer in and have IV anti-biotics. This has been oked by my midwife.

You may find this interesting reading it's the latest Cochrane Review on IAP (Intrapartum Antibiotic Prophylaxis).

Don't forget that IAP has side effects for both mother AND baby. It is not a risk free procedure.

[justineandcarrieneedanewlawyer]

take it seriously.
fuck the fannying about with garlic.
the antibiotics could save your baby's life.

www.gbss.org.uk as linked above is very good.

[Yorky]

I found I was GBS+ with 2nd pg, not tested in first, and chose to go ahead with planned HB without ABx, as long as I had no contraindications, as mentioned by Verity79 (good luck to you)
Both kids are fine.
The line you mention on the NHS site was my mantra, I clung to my belief that I had been GBS+ with DS and just didn't know.
Like you I labour quickly and there is no way I would have been in hospital long enough for the ABx so be effective - if we'd got there before DD did!
Remember ABx are a CHOICE, they carry risks as well

[Verity79]

True it is fannying around with garlic BUT if it works and you become GBS -ive then great. If it doesn't then you can go for the antibiotics in labour if you and your drs decide that is best for your situation.

What have you really got to lose? The cost of a bulb of garlic and some really bad breath?

Yes GBS can be a really nasty infection to have BUT being colonised with GBS does not mean that any of your babies will be infected with it. 30% of women are colonised with GBS but 30% of women don't have IAP or end up with a sick or dead infant. Obviously it does happen but it is not a given.

[justineandcarrieneedanewlawyer]

It happened to me. If I'd been priveleged enough to have the information that I was a carrier then I would have chosen antibiotics in labour over what happened to DS1 and the decision would have been an easy one.

But maybe only an easy decision for me because i know what it is like to love a sick baby who is ill with an infection i gave him.

[Verity79]

JACNAL - I'm really sorry your DS was ill with GBS. I hope he is fully recovered now.

The point I'm making is that if you know early on in pg that you are colonised with GBS and there is a chance you could get rid of the GBS before labour wouldn't you do it rather than just rely on the last resort of IAP? If it doesn't work you have the fall back position of IAP but if it does then you can labour with one less intervention (of course if you then develop a fever, etc IAP is then a very valid and neccesary intervention).

[beepbeep]

My point is, I am -ve for GBS in this pregnancy and they still want to give me antibiotics. I am happy to have them if I show any other risk factors (i.e. high temp etc) but otherwise, according to NHS and GBSS websites they should not be given, so why does consultant say I should have them?

I intend to do the private test for GBS at 35 weeks, obviously if +ve then I will have the antiobiotics.

BUT, if not then I believe that having the antibiotics is actually more detremental to baby than the risk of GBS as there would be NO risk factors in this pregnancy so far.

Personally I'm not one for the garlic treatment, if I have a +ve test in this pregnancy then I'd like the treatment.

[Verity79]

I'm certainly not one to say anyone HAS to do something but for me personally, an ounce of prevention is worth a pound of cure. I completely understand that it may be a bit hippy dippy for some/most/99.9% of people.

I absolutely agree if you are GBS-ive then no antibiotics are needed if none of the known risk factors are present during labour (especially as you have had a child while you were GBS+ive and still not infected him!).

To be honest I'd print off the GBSS/NICE/Cochrane Review and take it to your next cons. appt and ask why he/she is going against all the current advice/data? Has cons. got a crystal ball that says you will be GBS+ive by the time you go into labour and infect baby????? I think not

Good luck Beepbeep with everything and fingers crossed for continuing GBS-ive status and an easy labour.

[justineandcarrieneedanewlawyer]

i didn't have a temperature.

[justineandcarrieneedanewlawyer]

..not during labour anyway, just later when i had septicaemia.

[bethoo]

if you have been tested positive it means you are the 30% of women who carry it in their vaginas so even if you show neg now it is jsut that at that tiime it was not active.
i have had to have AB IV in both my labours but becasue they were so fast i never had time to have both doses so i ended up staying in for three days for obs, for baby not me.
it is not a risk worth taking so i would have the IV.

[bethoo]

surely if taking garlic was a cure then no one would have it? not that easy, if you carry it you carry it, just that it is not active 100% of the time. i only discovered i had it in a routine urine sample. that is why you dont actually get swabbed as you can be a carrier but the bacteria is not active at the time of testing.

[beepbeep]

have spoken with my MW who was great, she agrees that i shouldn't under a consultant and also shouldn't require the antibiotics unless i have a +ve test late on in pregnancy, so now we just need to battle the hospital!

[dikkertjedap]

Personally I wouldn't take any risks and go for the anti-biotics.

It was thought that when my dd was born she had strep B (I had never been tested) - I don't want to go through the awful details of tests done on her and treatment (she is a healthy 3 year old now) but it has traumatised me for ever.

I would do absolutely everything in my powers to avoid such a situation, so if I were in your situation I would go for the anti-biotics. Labour is only the start of hopefully a young person's life and those first few weeks can be so traumatic for parents and child if very intrusive medical intervention is needed due to something like strep B.

I think that there is too much focus on labour itself rather than what happens afterwards. Whatever you do good luck to you and your baby.