Sweep and Group B

[sassie23]

Hey all impending sweep being offered on Thursday at 38+5 due to growth scan predicitons. Would go for it normally but Im worried about infection risks because I tested positive for Group B at about 28 weeks. Has anyone else out there went ahead with sweep knowing they have GBS love to hear your experiences thanks

Hi

You know from antenatal that I'm having the same dilemma (Thursday for me, too). I found this on the group b strep site:

Are membrane sweeps safe for women who carry GBS?
Using a gloved finger passed through the cervix (neck of the womb) to separate the baby?s membranes from the lower part of the uterus is known as a ?membrane sweep?. In women who are at or beyond the due date, it encourages spontaneous labour and can enable about 10% of women to avoid an artificial induction of labour.

There is currently no good evidence that membrane sweeps are harmful in women known to carry GBS. Indeed the results of trials of membrane sweeps don?t show any increase in problems caused by GBS in women having sweeps, and it is highly likely these trials would have included many women carrying GBS at the time.

However, there remains a theoretical risk that a membrane sweep might occasionally introduce GBS into the uterus, and so our medical advisory panel advises caution in using a membrane sweep for women known to carry GBS when there are other acceptable alternatives (for example, induction of labour with prostaglandin gel introduced into the vagina).

Obviously I'm a vbac, so no prostglandin gel for me...

it's near the bottom

I'll be really interested on what others say.

Yea thanks I've read this too Moonstorm. This is what originally made me sit up and question the doc's suggestion at the last appoint. Of course I forgot to ask her about GBS at the time only after I came out and thought about it all properly. Im wondering whether she missed all the big GBS Alert stickers over my file or whether she wouldn't have any concerns. She did say at one point when I showed surprise at being offered a sweep this time ' Oh we're sweeping everyone who comes through the doors now ' which was a tad disconcerting

I too have gbs and am now 39+3. Have a dr appointment on Tuesday (39+5) so will be talking then about sweeps and induction. I have wondered aswell
about having a sweep done with the infection. I have no idea if there is any evidence but I kind of think I might say no to a sweep or induction, there's no reason for me to be induced in any form at the moment though. I just don't know.

Will be keeping my eye on this thread!

Will be interesting to hear what they say to you tomorrow NoTeaForMe will you share your docs advise. I wouldn't be considering the sweep so early either if it wasn't for them constantly telling me how big this baby could be but then again how reliable are growth scans?? First DS was 9lb 12oz but then he was 12 overdue so confused

I would be reluctant to have a sweep if I knew I was GBS +ve, but it would depend on why they thought the sweep was a good idea.

Re. induction for a large baby, you can download the pertinent NICE guidelines here, which state on page 44:

"In the absence of any other indications, induction of labour should not be carried out simply because a healthcare professional suspects a baby is large for gestational age (macrosomic)."

The gist of the section before that recommendation was that you can't predict a macrosomic baby with any accuracy and induction has not been shown to improve outcomes (reduce need for EmCS, assisted delivery).

If the sole reason for suggesting a sweep was because they thought the baby might be large then I'd be declining if it were me...

I will of course let you know what the dr says tomorrow. I don't particularly have much faith in my doctors surgery/midwife though. I have seen different people throughout and have been told a few contradictory things re gbs. I'm seeing yet another different person tomorrow so will see what her take on the whole thing is! I'll come back and let you know though.

Thanks for that Tangle it makes very interesting reading don't think I would like to go much over my DD with the large baby issue in my mind although everyone who sees me including community midwive thinks my bump is quite neat and it measures right for weeks.They have basically scared me as we weren't expecting such large baby last time and never had a growth scan. I would really like to get a spontaneous labour this time so trying all I can think off to help it along

A side issue....

Did you have GBS in your urine by the way or was it detected on a vaginal or rectal swab?? If vaginal or rectal, you might no longer be a carrier. It can come and go.

Only on a vaginal swab at about 28 weeks, yea was thinking about that too but think it would still be a good idea to have the antibiotics at delivery as a precaution

Totally up to you of course....but I wouldn't have them if they weren't necessary. It means, for one thing, you might have to go into hospital earlier on in your labour than you might otherwise have to, and are likely to have to stay for a short period of monitoring afterwards rather than have a quick discharge. Or at least that's the protocol where I am.

Doctors Lab and similar companies offer a private test (more reliable than the one available on the NHS which is notoriously unreliable) and my results from them were back within 2 days.

I'll butt out now!

thanks for that advice I'll look into it

gbs can come and go but my MW advised me it's unlikely to go within the period of one pregnancy. mine was picked up at about 26 weeks during a swab i had wheni had a bad dose of food poisoning. my MW said it would be worth having another swab in a subsequent pregnancy (or is that routine anyway?) though.

i had a sweep,to be honest i didn't know of these risks or i may not have done so. tbh, you're not missing much by having a sweep anyway, imo there are very few people it actually works for. the main benefit i had from my sweep was it got me used to what to expect fromthe numerous internals i had to have for my very long induction. it probably wont actually start your labour- in fact a consultant I saw a week before my sweep was very dismissive of it and thought it was a waste of time - so maybe try all the other methods they talk about...

yea thats what im thinking muslimah28. It will be too early for it to work and could end being ahem uncomfortable until i finally get started think prob best left alone [sceptical]

FWIW sassy I had a positive GBS at 37 weeks, and last time I saw the MW she said 'oh, we'll give you a sweep at 40+2, next time we see you'. Like you tho, I don't think I'm going to go for it.

I was also supposed to be having a sweep next week at 39 weeks due to growth prediction but it was so much hassle trying to get someone to do it (in our area midwives can't do until you are term and there were no doctors appts left etc etc) so I have given up - apparently they rarely do anything before term anyway and I am hoping a week isn't going to make much difference ..

Hi all,

I had my appointment with the dr today. When I asked about having a sweep with gbs she said she had never thought about it and had never been asked before!! I explained what I had read thanks to moonstorm and the dr said she could understand all of that and the logic behind it, so if I preferred I could just not have one. I can still be induced in 2+ weeks time if needed but not necessary to have a sweep if I don't want one or feel it's the best thing to do!

I personally will be declining a sweep if it comes to that. I have another appointment booked in for a weeks time to discuss the next step and am hoping things kick off naturally before that!

Sorry that's not much help!

Thanks for that NoTeaForMe just can't believe the doc admitted she'd never thought about it before well they'll prob say similar at my appoint thursday so I think I'll be declining a sweep myself. On a more positive note went to my reflexologist today and she said my feet were definitely gearing up as they were so hot to touch she thought the hormones were racing around my body getting me ready for baby. I would normallyu be quite cynical of things like this but I really think reflexology is quite amazing now good luck everyone

Aaargh - I still can't decide. My biggest dilemma is that chemical inductions are out due to VBAC. It's sweep, them balloon cathetar (which I will decline), or if nothing happens, cs...

Can't decide which is worse a theoretical, but devastating risk, or another cs.

Hi all

have been watching this thread with interest as Ihave also tested positive for Group B Strep (vaginal swab done through private clinic after hearing about it through friends) I am 40+2 today and have been offered a sweep but also have slightly high blood pressure and odd bloods taken today so feel a bit pressured although pre-eclampsia didn't get positive diagnosis. I feel if the sweep doesn't work, which I hear it often doesn't, I'll have to go down the route of induction via gel etc anyway so in a dilemma what to do. Also worried about the risk of infection though nothing been proven it seems more likely after someone has been poking about up there! Am also worried how much sweep might hurt! The hospital have asked me to go back on Friday for another BP check and more bloods to monitor me, doctor there says risk of infection is very low unless waters have broken. Am very confused what to do for the best. Good to read other peoples opinions/ideas on everything. If you were overdue would you still think twice about having the sweep?

I think I may still think twice about having the sweep even when I am overdue (can you tell I'm not expecting to be on time??!!). Like you Yorkie1 I don't fancy it, partially owing to the discomfort factor - ridiculous given am about to go through labour.

Also, in my case I have to take my toddler to the midwife appt and it is always fun trying to keep her entertained while the MW does her bit. So much harder I would imagine when the woman is trying to do a sweep...

Induction via gel might be gentler yorkie and less risk of infection, however theoretical.

I agree with narmada I think I would still say no. I'm not quite at that stage yet, (am due tomorrow!) but I would hope that I would go into labour naturally and if not then I would take the induction at a later date. At the moment I think I will carry on saying no to a
sweep.

Hope that helps

Think I would agree with narmada and NoTeaForMe tell them your concerns about the sweep and try not to worry about the induction process too much my first took only one pessary and wasn't too bad. Baby may well decide to come along of its own accord before then. Moonstorm I didn't realise your siuation was more complicated because of the VBAC not educated on that score ,don't know what I would do either in your situation, just make sure you get them to expain everything on thursday sorry thats not much help

Thanks for the advice.
I still feel I should wait a little bit but no alternative has been offered (i.e. gel etc) I wouldn't really mind the induction, I just want baby to come out safely now and feel like the longer I leave it the riskier it gets - although am well aware people have babies 2 wks + past their due date and all is well. I suppose it's just 1st time nerves!
They don't seem to see Group B as a risk unless your waters have gone or you're pre-term so the doctor I saw yesterday suggested I was being ridiculous for worrying about it. Not very helpful!!

Well no sweep offered anyway no go area at the moment so looks like it will be a while. They seemed much happier with baby still guesstimating 8lb 10 at the min but Im not convinced about these growth scans. Doc assured me that when the time is right for a sweep she would not be concerned about infection from the GBS but can't say Im totally convinced by that. Going back nx Fri for yet another growth scan and then think about induction

Sassie are you me?

Just coming on to report back! I wasn't offered a sweep either and have to go back nest Friday . They mentioned the sweep and I asked about the strepB (and about the risk of membranes rupturing therefore setting the clock ticking) and they suggested (they= registrar and midwife) waiting until next week and assessing me for a swweep then. I think I'll feel differently about a swwep next week as it's so near to the limit before offering me a cs that if the membranes rupture and I have antib's, then hopefully labour will be more likely to start...