Group B Strep/ Fast previous labour / when to go to hospital?

[poppynic]

Hi. I'm currently 41 weeks. Got checked and had a sweep today. Apparently cervix is soft? and I'm 2cm dilated. No sign of contractions though.

My question is, I supposedly need 4 hours of antibiotics during labour to deal with Group B Strep. My previous (first) labour lasted 2hours 2 mins from time labour established and the midwives then said I had better get to the hospital quick smart next time.

I guess it's a bit of a "how long is a piece of string question" but I'm wondering if anyone has any advice about when to go to the hospital to ensure I get my 4 hours of drugs before birth - as I don't want baby having to have them after the birth, as that is the alternative.

Two midwives have told me when contractions are 5 mins apart but I really can't see me lasting 4-5 hours from then. Any advice greatly appreciated.

poppynic

It would be clinically unsound and pretty downright stupid of the midwife to start synto an you without giving you the AB cover that you need, especially as you are having a second baby.

I think it would be appropriate to dig your heels in a bit and refuse to start the syntocinon until you had been given the ABs, however I dont think it will come to that.
If you make it very clear to the midwife about your concerns, Im sure they will comply without any fuss.

Yourself and the midwife have to work as a partnership during your time in the labaour ward and its in everyones best interest that the relationship is cordial and equal and not strained and confrontational.

Thanks, will do my best ...

Hi Poppynic, see you are still on the board so haven't gone into labour. I had my 1st child in 4 hours and my second came within 2 hours. I knew before my contractions started that it was all about to start (I am sorry if it is a bit gross but helping out a fellow mother) as I had to go to the toilet and empty my bowels a lot and that was an hour before my contraction started. It may be the same for you. good luck

Sorry only read half the thread,

Plesase go and get your IV antibiotics!

I was group B strep positive and I did't get my antibiotics until an hour before - My baby contracted a group b strep infection and nearly died. She spent 6 weeks on life support with collapsed lungs and sceptiacemia (pls excuse spelling)

Its extreamly important it will reduce the risk don't let them fob you off! You have to have it 4 hours befor baby arrives or as soon as possible for it to cross the placenta!

Sorry I can calm down now!

This was my second baby - I was group B Strep positive with my first baby too but she was fine, my second baby was born by CS, they told me there was no risk of infection and refused to give me the antibiotics until just before I went into theatre. As GBS can be anywhere in your body including the intestines you are at the same risk when having a CS. I researched it whilst my baby was fighting for her life. GBS can travel in your blood, its essential you have the sufficient level of antibiotics befor birth to help prevent the baby contracting the infection, the infection shows as a grunting to start with, they then contract meninjitis, septiacemia, phenmonia (all treated with antibiotics).

A group b strep infection can either be contracted straight after delivery (within 24h) or anytime up to 3 months later where it shows as meninjitis, most diagnosis at this time is not linked with GBS.

I asked alot of questions - my baby had a team of her own from great ormand street hospital they came to her as she was too sick to travel. Its something I wouldn't wish on anyone - all for the sake of a dose of antibiotics!

(please excuse spelling)

Hi Hillary, thanks for posting, your story sounds horrendous and will bolster me in any efforts I might have to make to ensure I get full four hours (my hospital's current cover time). Am booked for induction tomorrow morning so hopefully that should ensure I get the full lot. Hope your baby ended up perfectly well.

Sallyfish1 - 2 hours sounds great.

Hi Poppynic,

Good luck with your induction, thank you for taking my post into account, I cant think of the times I spent sobbing in the toilets begging god to spare her! It makes me angry all these cut backs and slap dash attitude of staff - you really have to put your foot down and demand it, don't let them fob you off stand your ground.

(appologies to any good nurses out there, you are very much valued)

this information leaflet from the RCOG may be useful

In my hospital, if you do not receive the antibiotics within 4 hours of delivery, the babies has 4 hourly temp, pulse and respitaions checked for 48 hours. Antibiotics are not routinely given.

The diagnosis of labour isn't necessarily made by the frequency of contractions only. If you have them 10 mins apart and they are getting increasingly more painful then I would go in.

Do you have GBS detected this pregnancy or is this advice based on last pregnancy?

RCOG guidance is that antibiotics are not required if GBS detected in previous pregnancy if baby was unaffected

Sorry - didn't see that you are getting induced tomorrow. You should get your antibiotics administered before they break your waters.

all the best for tomorrow poppynic,,..will be thinking of you x

Thanks Mears and Lulumama for your advice and good wishes... (GBS detected this pregnancy) - hopefully will report with good news soon...

My GBS was detected in first pregnancy, I was given antibiotics, I wasn't given antibiotics in time in my second pregnancy and my baby got a GBS infection!

These guidelines are

Sorry forgot to say my first baby was fine.

Good luck tomorrow poppynic - Ill be thinking of you

I've read this thread with interest. I was about to say something, but Mears already beat me to it.
I just want to add that if you're really worried about a quick labour to just go in when you start feeling regular contractions that are getting increasingly painful. Don't really look at how far apart they are. If you think there more than braxton hicks, just go and they'll assess you. With your history of fast labours the hospital will most probably offer you the option of staying in and see how things progress even if you're not in established labour when you get there.

Hillary - I am sorry to hear of your experience 2nd pregnancy. Out of interest - did you have a swab taken second pregnancy? ATM we treat women as once a carrier, always a carrier but RCOG guidelines don't state that. My feelings are that because you can get false negative swabs, we should just take the approach of once a carrier, always a carrier. It would mean perhaps unnecessary ABs however I am not sure that it is worth the risk of what happened to you.

Hi there mears,

No I didn't have a swab taken on my second pregnancy, the clinic said what you just said once a carrier always a carrier, I was told I would be given antibiotics 4 hours prior to birth but when I went in as I was having a CS they refused stating it wasn't necessary with a CS. My waters hadn't broken and all was well but my baby tested positive for GBS infection. Another lady was having her baby a couple of days later via CS who was an exact case study of me, after what happened to me she was given her antibiotics 4 hours before her CS and her baby was fine if only I'd had mine!

I think if your GBS+ you should get your antibiotics whether its your first baby or 8th baby and you should have regular monitoring leading up to Due Date, if you are liable for a quick labour then you should be admitted a week before your DD! Its playing with lives and its just not worth it not when it can be prevented, like vaccinations they're not guaranteed but you try and get out of not having them! After all they are immunising you against the same infections as you get with a GBS infection!

Thanks Hillary. Did your DD totally recover?

Hi Mears,

My dd's 9months old now and is free from medication but she still has to go for 3 monthly check ups as they used trial drugs on her which had never been used before so she has to have regular blood tests and scans as they were concerned about her hart & other vital organs. She's still not allowed to fly due to the cabin pressure and we were advised that the sea air would be more benificial to her health as there were less poloutants in it as there was an increased risk of lung infections, so we upped sticks and moved.

One of the drugs they tried on her was Viagra - although it was in a different name, it worked wonders, she was dependant on two drugs which had to be agreed and signed for by the top dog but they were administered through an AV (I think that's what its called) line in her belly button which goes into the artery instead of vein, as she was on them for so long they had to get her off them due to risk of infection from the line, any minor change made her sats drop considerably, - She has 4 volume folders of notes!

The team have been happy with her progress so far - you sound like you work in the medical profession? - I feel like I could qualify after all this

I am looking to raise money to buy new equipment for the SCBU unit so watch this space........

I am a midwife Hillary. Thanks for sharing your story. Although the numbers of babies affected are few, that is no consolation when that baby is your and the infection could have been avoided. I am not comfortable with the RCOG guideline stating that GBS detection in previous pregnancy does not warrant IV antibiotics in labour if baby was not affected. Your story confirms that.

Hi there mears,

Well I'm happy that you are a responsible person who can advise ladies properly who are group B Strep positive. I don't agree with these guidelines either, they should be changed, its playing with lives and its wrong. The person who passed these guidelines should take a look up at SCBU thats all I can say.

No news from poppynic yet?