To think Strep B tests should be offered to all pregnant women?

[plinkyplonks]

Hadn't even heard of Strep B if it hadn't been for Bumpfest.

My midwife says Strep B tests are not offered as standard on NHS!

Please, please, please consider signing this petition if you think this is a test that should be offered to all pregnant women:

epetitions.direct.gov.uk/petitions/60515

It is not about money - from the NHS here

The current UK rate of early onset GBS is comparable to that in countries in which screening is recommended.

Screening makes no difference.

Sorry, that should be universal screening. Risk based screening may make a difference and is recommended in the UK by the NHS.

Agreed, should be done at about 36-37 weeks. Every GP I know has self-swabbed just before going on maternity leave.

letsplayscrabble - not too surprised to hear that. My midwife thinks it will be standard practice to screen for it in a few years time.

It's just a shame in the meantime that mothers and babies are at risk due to poor information and choices available.

After my waters broke following induction, I got an infection due to GBS. It made me feel really crap during labour, hampered progress, and my heart rate was indistinguishable from that of the baby. I ended up with an emergency c-section and a baby at risk of infection. Although our dd in the end was okay, her first week of life was very stressful for us. I would never want any parent to share our experience. And our experience is by no means the worst.

Signed

I tested positive. Hospital still did nothing.

As in, no anti-Bs during labour even though I mentioned it.

Bit of a waste of time if they don't bother their arses when your in hospital.

Signed. Having watched a close friend have a baby with GBS infection (thankfully he was fine, but after a very scary few days) I paid for private tests at 37 weeks with both dc and was positive both times. I had IV ab's with both and still managed the water birth I wanted for dc2. As I knew about GBS and seen first hand the effects it can cause, it was never an option for me not to test. When my NHS midwife realised I had paid to have it done privately, she said she would happily have requested it on the NHS as she and all her colleagues believed it should be routine.

Would sign if I still lived in the UK. I had never heard of Strep B until my baby was lying in NICU. Why would I know about it? I had enough on my plate dealing with my mental health throughout pregnancy and not to overburden myself with even more worry when there was already a chance my daughter would be born with a heart defect. Or should we Google everything about every possible illness out there and whip ourselves up into a frenzy for nine months?

There are some supremely insensitive and ill informed comments on here. Do some posters not realise what actually happens when a baby is taken down to intensive care with a blood infection? They can't tell you at the time what infection it even is. All DH and I were told at first was that it was suspected meningitis. They had to do an epidural on my newborn, held down by two nurses, to remove spine cells to test in a culture, for which we had to wait two days for the results. They had to search over here who tiny body to find a suitable vein to put an IV in. Including her scalp. Blood tests didn't show what the disease was, but only gave a historic picture of the spread of infection. Oh, and if it happens over the weekend the results take even longer to come back due to fewer staff on shift in the labs. Until the culture results came back we had no idea what was going on asides from the fact they were treating her with a stream of different drugs to combat the infection. We heard it was 'just' Strep B on the fourth day and we were relived it was not meningitis as Strep B was easy to treat in comparison and with no long term impact on our baby's development.

When you wake up in the middle of the night to be told your less than 24 hour old newborn has been taken to intensive care with some form of aggressive and possibly fatal blood infection then by God you want to know what the options are/could have been. Yes in a normal uneventful labour the chances are very slim but the chances are massively increased in a long labour of infection. My beautiful daughter survived thank goodness and is healthy and happy now. But for the want of a simple test and a course of penicillin we went through weeks of trauma which I am not sure I'll ever get over. I'd much rather a quick course of anti biotics than watch my baby screaming in pain and wondering if she is going to make it, feeling totally and utterly helpless to do anything but hold her and will her better.

YANBU and good luck with the petition. An awareness campaign to teach the signs of infection and possible causes could be really beneficial information when considering options pre and post labour.

I don't think anyone has been insensitive at all, let alone supremely insensitive? Its not inherently insensitive to disagree surely?

The test isnt infallible, but countries that test for gbs have seen the number of cases half!

I asked for a test and was told no. I thought of that often when I was visiting twin 2 in intensive care, watching his breathing being assisted with a ventilator. And I thought of it often visiting twin 1 who was in high dependacy. I wished I'd had my own private test done, would have saved a lot of heartache. My boys are well now, I'm very lucky but we could been spared all of it for a simple test.
Please sign the petition.

I gave GBS to DS2. He was born flat,with an Apgar of 1. He was transferred to intensive care in a hospital forty miles away. When they took him away Iwas told that they didn't know if he'd be alright. At that point I hadn't even been allowed hold my son.

Testing would have given me options. Testing would have enabled me to minimise the risk of infection. Testing may have prevented him from being born so ill. That's why I am signing.

I got lucky. I got the most wonderful, determined, stubborn, single-minded, positive boy in the world. He fought, he won. He's amazing.

I'm sorry to keep introducing data to this discussion, but only 50% of women who are positive at 35 weeks are positive at labour and 10% of women who are negative at 35 weeks are posotive at labour class="underline">consultationversion.pdf here

Whilst I fully sympathise with anyone who has been through this, universal screening does not have any benefit.

I was Strep B positive in my last pregnancy. I'm in the US, but had a midwife. My midwife is low intervention in most respects, but felt that the antibiotics were important, especially as I also had risk factors from having gestational diabetes.

In any case, I was admitted to hospital at 39 + 5, strapped to the IV for a wee while and given antibiotics, induced with a small amount of Pitocin (due to aforementioned GD), and baby was born four hours later in perfect health.

The problem is that it's transient. So you can test positive at 35 weeks but then not have it by the time you're labour. You would then be having unnecessary intervention.

Conversely you can be falsely reassured by a negative result.

If testing were to be routinely introduced I think it should be done when someone presents to hospital IN LABOUR. Because that's the only time the result is really important. Of course, there's time and cost implications to this.

I don't think it boils down to anything half as simple as requesting routine testing for all women unfortunately.

It is the preoccupation with idealised birth experiences a bad case of entitlement if ever there was one and how that ideal is prioritised as a value above the need to test pregnant women at 35-37 weeks so that babies do not end up dead or brain damaged if an infection is present that is baffling, and insensitive.

Universal screening has absolutely no down side. And women and babies stand to gain immensely, because the danger is there and known to be there.

The Royal College are flying in the face of proven experience from many other parts of the First World.

'I don't think it's the job of the NHS to educate pregnant women about something like this. We all have access to google'

The big problem with that is that we don't know what we don't know, do we?

("there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns the ones we don't know we don't know." Donald Rumsfeld got at least one thing right.)

And it is hard to google things we don't know we don't know..

I don't think it is proven though mathanxiety

The NHS educates women about all kinds of aspects of pregnancy and childbirth that could just as easily be googled.

It could save so much time and money though, to just say to women - 'if you have any questions, just google.'

You can bet your bottom dollar that if something is routinely tested for in the litigation-happy USA, health insurance companies have evidence that it should be done. In this case, the CDC has evidence that it should be done too.

'A large population-based study conducted during 1998--1999 demonstrated the superiority of culture-based screening over the risk-based approach to prevention of early-onset GBS disease**. The study found that culture-based screening resulted in the identification of a greater proportion of women at risk for transmitting GBS to their newborns. Furthermore, women with a positive antenatal GBS culture were more likely to receive intrapartum antibiotic prophylaxis than those women with a risk-based indication for chemoprophylaxis. In 2002, CDC's guidelines for GBS prevention were updated to recommend universal culture-based screening to determine which women should receive intrapartum GBS chemoprophylaxis. CDC recommended that women with unknown GBS colonization status at the time of delivery be managed according to the presence of intrapartum risk factors.'
www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm

**Schrag SJ, Zell ER, Lynfield R, et al. A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates. N Engl J Med 2002;347:233--9.

From my limited experience, the problem is not lack of compulsory testing, it's lack of awareness / understanding of GSB within midwifery. Now I am not a HCP , only one dc and know a lot of people do know their stuff. However...

I tested positive over ten years ago; twas found by accident when being tested for something else non pg related. Fast forward to last year when I fell pg. I did what I was supposed to do and informed my gp and mw of previous history. God! I got different advice and a lot of patronising lecturing at every interaction - and I moved during pregnancy so saw 2 gps and I think over 4 midwives. I was told...

• must have iv and labour ward delivery
• would under no circumstances have above unless other risk factors present
• would need iv but could still be low risk
• that I would be treated as positive, and that I would be treated as negative (this by same midwife on different occasions!)
• that I couldn't have a test on nhs, then that I could (again same midwife)

Eventually I had a test at 37 weeks, negative, made sure everyone knew history when went into labour so they could watch for risk factors and was fine. Only to be lectured by pediatrician in hospital for having been irresponsible with my dd's health. WTF?! I'd even asked to see a consultant during pg to help resolve all this conflicting advice, and been refused.

Pfft.

So, I'm not sure what the point of testing is - until and unless there is consistency and awareness of how to deal with results. At least within each individual area. I am not fool enough to expect consistency across the entire country.

It's just not that simple. Strep can come and go.

I tested positive at 39 weeks, so my hopes for a natural labour were out the window. Caused me a lot of extra worry, had three lots of IV antibiotics during long birth, and was never convinced I needed them.

Statistically, your baby was much more likely than the baby of a woman who tested negative to be infected. If you had a long birth then you most likely did need them. The fact that you were 'never convinced' you needed the ABs could have been remedied by better communication from your HCPs. Statistically and because of the way medical events turned out, your baby was at risk without the ABs.

Do you not think having your baby taken to a NICU would have caused you worry?

Signed.

Someone I know lost her baby due to GBS. Heartbreaking.

She's turned their tragedy into a reason to raise funds and, importantly, awareness of GBS.

You can read her story here and if you've got any spare coins perhaps donate?

www.justgiving.com/Sydney-Bennett

In general, I think that the UK antenatal system is very inconsistent in its approach to pregnancy/infant risk factors.

Tons of info about SIDS. And rightly so, as the Back to Sleep campaign has been hugely successful in reducing the numbers of SIDS deaths.

Somewhere between none and very little info about stillbirth, post natal mental health problems, GBS, PROM, placental abruption etc, which have a higher rate of occurrence than SIDS.

I don't know enough about the efficacy of universal screening for steep b, although there do seem to be risk factors which should trigger investigation/testing.

I paid to be tested privately with both my living children, and had antibiotics during labour wirh my ds which turned out to ve unnecessary as he was born in his water sac.

More research and cross nation comparisons of practice and rates needed, I think, as well as close attention to what is known about current risk factors.