Group B Strep - do they test for this in labour?

[WorrisomeHeart]

Hi all

Have been reading a lot about Group B Strep and getting myself in a bit of a flap. I've not had any tests for this during my pregnancy and now at 40+4 am wondering what will happen if I do have it and what this means for the LO. Is this something they routinely test for when you go into labour? Is it something they test babies for initially, or would it just be if he started to show signs of illness? Am I getting my knickers in a twist for nothing?

Tx in advance for advice!!

No they don't test for it on the NHS. YOu have to pay for a private test. Bit crap really.

I never really understood the approach to testing either.

I have tested positive for Strep B, but this information came out of tests unrelated to pregnancy.

Because I had Strep B, along with a couple of other factors (large baby, notch on one of the arteries in the womb), I was considered high risk. This meant I couldn't have a water birth in the nice mother & baby centred bit of the hospital (I forget now what it's called) that I would have preferred and had to have the more medical approach instead. In practice this meant I had have continuous monitoring and the midwife strongly encouraged me to stay on my back (which was not what I wanted to do) although it's my understanding that a more enlightened midwife could have monitored us fine without subjecting us to this.

I'm really not sure if Strep B alone makes your birth high risk though.

Although lots of people do have Strep B, and they take it very seriously if you do have it, it seemed to me that my health authority didn't test for it as a matter of routine, which didn't any make sense to me!

It's worth bearing in mind however that even if you do have Strep B, the chances of it adversely affecting your baby are very small indeed.

The main lesson I learnt from this is that if I do give birth again. I will make sure I discuss with the midwife how she is going to deal with the monitoring, and if her approach is to insist I'm on my back for the labour, I will insist on asking for another MW. This will be the most important (possible the only!) thing on my birth plan.

I would advise speaking to your midwife about this. At our hospital, we could ring up the midwife team with any questions - can you do this? (Might be worth just ringing the hospital and asking if it's possible to speak to the MW team).

I hope that's helped - and not worried you too much!I hope someone can answer your question soon.

Cross posts CrazyPlateLady. Do you know what the reasoning is behind this? It doesn't make any sense to me!

No idea I'm afraid. I just remember reading a leaflet in the surgery about Group B Strep. I was getting worried about it too and it said in the leaflet that they don't offer the test on the NHS and if you do want it, you have to pay privately for it.

Bit crap really.

Oops, put that at the end of my last post too. But then it is crap.

The reason they don't test for it is partly money and partly becasue the test isn't very reliable. I'll try and explain. Up to 60% of people may have it any time and it doesn't cause problems. The test takes a minimum of 48 hours to grow a result. If you have GBS you can have it one week and not the next. So when do they test you for it?

They can't test you in labour as the result won't come back soon enough. They could test everyone at 39 weeks but then if you don't go into labour for another week or another 3 weeks then the result will be invalid. They would still treat you as if you were positive if you'd had a positive test at some point but this would mean that a lot of people would have IV antibiotics for no reason, along with all the restrictions in labour that come with this. Plus if you have a quick labour and don't get 2 doses 4 hours apart then baby has to stay in for 5 days and baby has to have IV antibiotics.

Plus there would be a lot of people who had nehative results who may actually be positive for GBS when they come to give birth.

Anyone whose waters break prior to labour should have a swab done. Hopefully if they don't start labouring for 24/48 hours the result may well be back before they give birth. Babies who have been exposed to a prolonged rupture of membranes will have a nasal swab taken and will be offered antibiotics if this comes back positive, though obviously baby will be a couple of days old by then.

Babies who show signs of infection will be swabbed and antibiotics started while waiting for the result. I think the most important thing for mums and staff is to be on the ball when it comes to recognising if baby is unwell or not.

Ahhh, that makes sense then. Didn't say anything like that in the leaflet I saw.

money saving - thats the problem. Yes you can have it one week and not the next, but if you have it near to birth then surely its safer the have the antibiotics just incase. I am paying provately to have the test - which is more reliable than the NHS one. My midwife offered me the screening, as I was concerned - so I will have it privately and NHS 9to be on the safe side!) Cant hurt, but will take that worry off my mind. Im sure if you explain to your midwife that you are very worried about this and insist they est you then they will.

privately not provately!!

Thanks folks, that's really helpful. Am going in for a sweep tomorrow so will try and remember to mention it then. My main worry is the transferral to the baby and I guess they'll/we'll be keeping rather a close eye on him anyway so will hopefully be aware of signs of illness.

Am possibly just grabbing onto things to worry about as he's not showing any signs of getting a move on out of here yet...

As others have said they don't test during/after labour. What it means for LO? Second day after dd was born we were re-admitted as she had jaundice, then they do a number of test and she had a very high score on one particular test (can't recall what it was called), was Monday night, few staff, no consultants, registrars were in a right old panic, and me as a result as well as they told me to prepare for the worst. They had to do a lumbar puncture and put her on very strong anti-biotics drips, apparently they thought that she might have Group B Strep. We had an absolutely awful week, we really thought we were going to lose her, then it turned out she didn't have it, and probably didn't even need the anti-biotics but I got very ill as I had a serious infection picked up during labour which had not been treated. So, it is good to get tested, because then at least you can exclude Group B strep right from the start, because you know you either carry it (and can take measures, anti-biotics drip during labour) or you don't have it and your dc will not have it and hence no need for invasive and potentially damaging treatment (she had very strong anti-biotics and we were told that if she didn't get them she would die but is she got them she might get deaf, luckily enough didn't happen).

My GP suggested that I get tested for it privately. His wife had recently given birth and he had researched it and decided that it was worth doing.

someone told me if you#ve had it once they retest you a second time on the nhs for subsequent pregnancies. but i don't know how true that is, or if that is just local protocol in some areas. if not i'll get a private test next time around having had it in my first pregnancy.

worrisomeheart check out this website for information on what to look for in newborns and older babies, in terms of symptoms of GBS infection:

www.gbss.org.uk/content.php?section_id=3&sub_id=12&content=GBS%20Infection

While the overall risks are low, I always think it's better to be as knowledgable as possible, but do remember that most women are completely unaware of their GBS status as they go into labour and their babies are fine!

In my area, muslimah they don't bother to test you even if you've been positive in a previous pregnancy. They just tell you you will be given antibiotics in your second labour. Seems mad to me. I paid for a second private test and it came back positive anyway, so will be having them.

My NHS obstetrician has advised me to get the private test done - the NHS ones have a higher rate of false negatives. My baby daughter passed away from early onset infection (don't know if was GBS or not) a day after her birth. I was neither tested before induction nor had any symptoms.

I am opting for a CS this time around. I asked my obst whether I would be given anti-biotics beforehand and he said there would be no reason to as babies catch infection if membranes ruptured or during labour. Does anyone have insights on anti-biotics if having a CS?

I had the private test done for Group B Strep and i tested positive. It costs £30. I only found out about Group B strep when reading a magazine article about a lady who lost her baby because of it. It's outrageous to think that women are not educated about this terrible infection. The NHS staff never mentioned it to me, I had to initiate a discussion about it but the midwife didn't seemed very clued up on it

I think you have to get the test done between 35 - 37 weeks. It's really easy to do, you have to take a couple of swabs and then you send them back.

When pregnant, I had thrush symtoms & was swabbed & tested, they found Group B strep. I was given antibiotic drip during labour & have read a few articles about how it can be v serious for baby. Not suggesting that thrush type symptoms is same as GBS, just it can be a way of being tested, if you are concerned , although it isn't always detected

Does anyone know - if you didn't have Strep B during your first pg, is it something that is likely to develop before a second one? Or is it something you either have or don't have?

Strep B is incredibly dangerous and can cause all kinds of complications and result in your baby dying...that is a reality. You need to go onto the Group B Strep Support website and order a testing kit which you can self test between 35-37weeks of pregnancy. There are so many woman on SANDS which is Stillborn and Neonatal Death Society who have bee told that their babies died due to Group B strep which stupidly the NHS rely on showing up in your urine but it is not an accurate test (you need a vaginal swab) and only 50% of cases are detected on the NHS...it's appauling. I think instead of dishing out £190 to every pregnant mum (which I know is coming to an end) they should use that money to test for GBS and to offer a scan at around 40 weeks to ensure baby is fine. 17 babies a day die in UK hospitals and so may could be prevented. The NHS gamble with our babies lives...I should know!

Actually, a big reason that there isn't a widespread NHS screening program is that there isn't any evidence that a screening program would improve outcomes.

The antibiotics carry their own risks - e.g. allergic reactions, thrush, reduced breastfeeding rates, higher risk of asthma & allergies in the child, etc.

The GBSS group do say that if you only have a positive vaginal swab with no other risk factors then IV antibiotics are not essential. There is a lack of evidence as to what is best to do in this situation.

Because of this, when considering a screening program, you have to balance the known risks of giving antibiotics far more widely against the small risk of some babies developing GBS.

Of those women who might have a positive swab result before labour, a vast majority would develop no symptoms and nor would their babies. So giving them the antibtiotics introduces a risk that wouldn't otherwise be there.

I do think there should be far more education about GBS. Many (most?) women would not know what the other risk factors are to watch for - e.g. fever in labour - and so might stay at home when they need to be getting to hospital for IV antibiotics whether or not they've had a positive test. And most new parents wouldn't have swotted up on the signs of GBS in newborns. They're real issues IMO.

Not true japhrimel - GBS screening is standard in many countries. This must be based on scientific evidence. Also, I attended a talk by a group who are researching a vaccine for neonatal infection www.devaniproject.org/
As part of their research, of all the mothers who tested positively for strep b, not one of them had a baby with an adverse outcome due to intervention.

I agree that there needs to be widespread education. Sadly, in my case, I had absolutely no symptoms but my baby died as a result of early onset infection. I had no clue at the time that her symptoms were due to infection, and neither did the midwives.

Screening would not prevent all deaths and antibiotics may not be effective in all cases, however, if strep b is picked up, a closer eye can be kept on those babies as the prognosis of early inset infection is pretty dire.

Should've posted that the lack of evidence that a screening program would improve outcomes is the official NHS response to why there isn't one at present afaik.