testing for group b sttrep?

[grizzabellia]

Following my last baby, now age 3, I had a coil fitted for a while. The pre-coil swab showed group b strep and I had to take some antibiotics before it was inserted. I am now 33 weeks pregnant, have not been tested for group b strep during my pregnancy as they don't do it routinely and have not had any UTIs or anything, when they sometimes pick it up. I asked the midwife about it and she said policy now is to give antibiotics in labour if it has been detected in pregnancy - but it seems a bit arbitrary whether this is the case as they don't screen for it! (I pointed this out to her and she agreed). She told me it is possible to send off for a private test to do around 36 weeks but I am not sure whether this is necessary - I don't want antibiotics if I don't need them. As far as I understand, if your waters break they do a swab then although often the baby might be delivered by the time they get the result. My last labour was fairly short so I am (maybe misguidedly) hoping this one will be too, in which case I understand chances of infection would be reduced even if I do still have it (and if I had not had the coil I would have been blissfully unaware of the whole issue!)

Has anyone else had this dilemma, and has anyone got any advice?

I tested positive in my last pregnancy so I am having a GBS test at my 36 week appointment to determine if I need antibiotics this time or not.

I also tested positive in my last pregnancy so my midwife said she'll test me again at 36 weeks in this pregnancy too.

It only costs around £30 to do the test privately (you do it yourself at home). However even if it was negative... you could still get it in the period between doing the test and giving birth. GBS can and does kill babies though and the NHS just doesn't have the resources to check everything out (as I know from a previous and sadly very unhappy experience). I will be having it.

I paid privately for the test in both pregnancies, the Doctors Laboratory do it for about £30, they send you a kit, you can swab yourself or get the MW to do it and they text you the results in 48 hrs. I think they recommend doing it at about 36 weeks to be as accurate as possible about whether you are likely to be carrying it in labour.
A friend had a baby who was affected and was v poorly, luckily he was ok after a stay in PICU. In subsequent pregnancies she was treated and baby monitored carefully and everything was fine. Even if you labour too quickly to have the iv antibiotics it is worth knowing whether your baby is at risk.
I can't understand why since the NHS insist on testing me for lots of pointless things (blood group - well it hasn't changed since my last pregnancy, sickle cell - have never been of an at risk ethnic group and still am not, HIV - was negative in first preg and certainly do not indulge in risky behaviour... Etc etc) they do not test for GP B strep.

www.gbss.org.uk tells you all you need to know/convince you :-)

I would defo have the antibiotics. They will save your babies life if they pick up a strep b infection during the birth. Sorry to sound melodramatic but it bugs me midwifes do not routinely test all pregnant women yet around 70 babies a year lose their lives to GBS infections. Agree with more granny about looking at the research.

I have thrashed this issue out with midwives and consultants repeatedly.
I had my last baby 15 years ago and got GBS last year. They refuse to screen me because they only do this if it affected your last pg.
Ive also got the shpiel about "even if you test negative/positive things can change by delivery"...
All very well, until you read the GBS website where it reports that countries which routinely test at 36 weeks have much lower rates of complications in babies than this country does.
DD has a hole in her heart. I have demanded the antibiotics for this delivery regardless. She doesn't need any more to deal with than she has all ready. The consultant I was speaking to at the time wasn't best pleased, but I dobt care. I'd much rather be safe than sorry.

Thanks for replies - thinking maybe I will get the private test now! What put me off was the midwife telling me that even if test positive at 36 weeks may not have it at time of delivery, and vice versa, so negative test not necessarily failsafe!

Sorry for the hijack, but I have to have an ELCS (baby physically cannot come out any other way, there will be no accidental vaginal birth) and I really can't tell if I should pay for a private GBS test or not - I couldn't easily find an answer! Does anyone know?

I ordered the test and have it ready to go, but you only pay when you send it off.. I'm 36 weeks today!

No point if you're having an ELCS as it's only transmitted via contact with birth canal.
GBS is a normal vaginal bacterium and I appreciate there are cases of infection but the vast majority of babies born to GBS positive mothers are fine. If we tested everyone women would have to be admitted to labour wards rather than have home births/ be in MLUs, it would cost a fortune and antibiotic resistance would rise.
Clearly there are cases where antibiotic use is prudent and if we know about GBS it is treated, but actively looking for it is another matter.

I had IV ABs in my last 2 ELCS.

This is because DD1 had a GBS infection, SCBU for 2 weeks, IV ABs every 12 hours. I think I was 'high risk' because I had passed it to DD1 in my first labour which was 30 hours resulting in a pretty heavy duty emergency CS.

You are routinely given IV antibiotics if you have a section, although won't necessarily cover GBS.

Sounds like you had a rough time of it Ubik!

If you are in the antibiotics for less than four hours, your baby may be given precautionary antibiotics for 48h

Long time ago now. And I have a beautiful, healthy 10 year old girl thanks to that medical intervention. Very grateful.

MrsM can I ask your view on the GBS website information i mentioned, that countries that routinely screen at 36 weeks have lower complication rates than the UK?

My baby was poorly from gbs and for unrelated reasons have had elcs for all my births and still automatically had iv antibiotics beforehand. Having seen the effects and been ill myself from the infection I would not hesitate/question having them. In fact I would put up a major fight if they suggested I didn't take them. I also have warning stickers over my maternity notes in case Igo in to early llabour to alert the staff.

You could say you're worried about an increase in vaginal discharge even if it's a lie: they would take a swab to check for infection. Laboratories then always check for group b strep: it's routine. A bit unorthodox.....

SaggyOldClothCatPuss I'm not disputing that routinely screening and giving antibiotics wouldn't cut neonatal complication rates. Of course it would- that is until the GBS becomes resistant to the antibiotics and we're all up sh*t creek without a paddle. My feeling is we shouldn't look for problems that aren't necessarily going to be problems, but have a low threshold for acting should need be.
Plus unlike many countries our health service is publically funded so, rightly or wrongly there are always financial implications to what we do and don't do.

Thank you all!