neonatal death from b-haem strep : should we screen?

[DrCrippen]

In the USA and Australia, all pregnant women are screened for b-haem strep infection. It is not done routinely in the UK, though we still do screen all mothers for syphillis!

Dr Crippen has a patient who just lost a baby from this infection, as discussed here \link{http://nhsblogdoc.blogspot.com/2006/06/beta-haemolytic-streptococcus.html\Neonatal Death from b-haem strep}, so it is much on his mind

John

Yes I think you should screen women for this there's posters about it all over our local womens hospital but they don't test for it unless they see it in your urine which means alot go undetected. There is a website which will provide the test for you in the post and you can take a vaginal swab at a round 37 weeks pregnant and send it off and pay around £26 for the results. I think it's ridiculous we don't get routinely test for this as so many babies get sick as a result of this infection.

I wish all women were screened. Not from personal experience, but one of my best friends has a son who caught this from her at birth. he survived (to her eternal gratefullness), but was left with cerebal palsy:(.
because of this she was screened during her next pregnancy (with twins) and was treated with anti biotics during pregnancy and then the labour. bot twins, altho prem, are fine:).

just found out two days ago that another family friend has had a little girl and she is now in intensive care at less than a week old with strep b meningitis:(:(. they don't know yet is she will survive and it is made all the harder as her sister had a baby boy the day her daughter was diagnosed. It is so very very hard for the whole family...can you imagine. Joy for the baby girl, then fear and dread, then joy for the baby boy but its hard to show because of the fears for the baby girl. I so wish it was screened for. It is much more common than people realise I think.

it was standard in Canada when I was there, although I declined as I had a planned CS.

Are there any symptoms at all in the mother?

ledodgyh - can you remember the name of the website?

Have never heard of b-haem strep (am 32 wks pg).

I found out when Dd1 was 2 years old that she had contracted GBS at birth, she was in SCBU as she was born at 31 weeks, I had Dd2 when Dd1 was 15 months and wasn;t given anti biotics during my pregnancy or after DD1's deliverly, because I wasn;t informed that I was a carrier.

BTW DD1 has CP too

She had Septacimea (SP??) when she was about a week old, which I also didn;t find out about until she was 13 months old.

I had no idea that it wasn't routine in the UK. Seems odd, as it is a really simple test. Had it with ds since I am in the US.

Yes, women should have the option to be tested. My daughter was subjected to many invasive tests awo days after birth due to suspected group b strep/meningitis, as it turned out I had picked up a hospital infection during labour (probably from a filthy bath in the birthing centre in the early stages of labour) and passed toxins to baby thru placenta. As a result of invasive tests (plus jaundice on top) we had a very traumatic start which could have been avoided.

I think it is crazy that something which can turn out to be fatal isn't tested for. I just don't understand why it is not stadard practice.

here is the UK-based support group, who are campaigning for routine testing in the UK \link{http://www.gbss.org.uk/\GBSS}

I only found out about this when dd1 was born, and it was casually mentioned I had strep b at delivery and was handed a leaflet to read. Only on reading this did I realise how potentially serious this can be. Thankfully, dd1 was fine, but I was left thinking it could so easily have been detected.

Second time around I had discovered mumsnet so was more informed. I understand the nhs test gives false negatives in about 50% of cases so had a swab done privately at 37 weeks. It was positive, but my midwife was very unconcerned and I got the impression she thought I was worrying about nothing. DD2 arrived a few days later, however, because labour and delivery was so quick there was no time anyway to administer intraveinous antibiotics anyway. She was fine, but the impression I am left with is that it's all a lotto and it needn't be so.

DS1 contracted a life-threatening group-G streptococcal infection during birth and we are eternally grateful to the urologist at Kingston who elected to transfer him to St.George's - PICU saved his life.

I know Group G is uncommon and screening for Group B would not have made a difference in our case, but our horrible experience has made me believe that the Group B test should be offered to all women, since so many babies still become ill.

With my second pregnancy I had HVSs from 36 weeks, induction of labour at 40 weeks, IV antibiotics during labour and 48 hours observation of DS2 (all tests completely clear).

But it took a near-fatal infection to get this (and an awfully expensive lot of treatment for both me and DS1 - flashing light SCBU ambulance transfer,pelvic ultrasound, lumbar puncture, PICU for 2 days, ward for 10 days, 16 doses of IV antibiotics daily, 8 daily doses of painkillers, operation to insert long-line in head and to drain abscess, head X-ray, visits from community nurse, oral antibiotics for another 2 weeks etc etc)

Can you tell that these things are hard to forget?

Yet another example of extreme short-sightendness on the part of the NHS. It'd be much, much cheaper to introduce routine screening for this than to treat those who fall ill w/it - often w/lifelong disabilities that will seriously compromise or curtail their ability to work, etc.

Hello DrCrippen

Myself and others have disussed the issues on numerous postings here on Mumsnet over the years

Have a look at

\link{http://www.mumsnet.com/Talk?topicid=138&threadid=4407&stamp=030526194002#scaddmsg\this old thread}

and

\link{http://www.mumsnet.com/Talk?topicid=138&threadid=20469&stamp=040429114834\this one too}

Plus if you search archives, there are a few more.

It is an issue many of us on Mumsnet feel strongly about and have done so for quite some time. A number of us have also campaigned to raise awareness of same.

Thank you for making others aware of it again through your post today. My sympathy extends to your patient.

butterfly :)

These are terrible stories. But if the only available test gives 50 per cent false negatives, I can see that there is an argument against testing. The test is almost useless. Half the women with Group B Strep would go away thinking they were in the clear, wouldn't be treated for it and would end up in the same situation anyway. And for those who did test positive, intravenous antibiotics aren't entirely risk-free either. Wonder what the false positive rate is, if any?

I'm not decided on this, but I can see the argument against testing.

Edam, it is my understanding that the ECM tests now available are more accurate, albeit not widely used by the NHS (I also believe that it is the NHS tests that give/gave 50% false negatives). The ECM test can be purchased privately, as detailed on the GBSS website.

My DS2 had group B strep and developed viral meningitis at 10 weeks. I'm not sure if the two were linked.

Does anyone know if this infection is linked to pre-term birth? I'm 26 wks and having 2 hourly ish runs of contractions every few days and just been told I'm positive for group b strep.

I found out I had group b strep after thinking my waters had broken the week my 6th baby was due. They did a swab to see if they had gone and then sent me home with some leaflets very scary. Ive since had two miscarriages but dont know if they were linked to the infection. Im now pregnant with baby number 7 and asked to be screened again but was told there was not much point they are just going to treat me as if I still have the infection even though it was over 3 years ago and hook me up to intravenous antibiotics anyway. I wish more would be done to determine if you do have it or not in each pregnancy and have the risks explained more