Strep B at 36 weeks

[harleq]

I had a midwife appointment today at 36 weeks and she told me I was positive for strep b. This had come from a vaginal swab I had back in April where the infection that was showing I was given canestan for thrush which never cleared up.

Ive obviously heard of strep b in the past mentioned but didn’t actually know what it was. Has anyone experienced this? Now I’ve come away from the appt I feel like I should have asked more questions (having googled it and seeing the baby could develop various horrible illnesses if they catch it). Should I push for a c section so risk is lower? I had planned for a midwife led birthing centre which is now out of the question and midwife has advised main hospital birth ward for IV antibiotics drip once labour has started.

When you Google it sounds like a huge problem but 1 in 4 women will have it when they go into labour without knowing it and it very rarely causes problems. It also comes and goes so you might not have active strep b now. You can be given antibiotics during labour to reduce the risk of go for monitoring of baby after birth.

Group B strep is really common to find, different countries have different screening recommendations. If your GBS was found on a vaginal swab back in April and you are now 36 weeks, then that result is actually a bit early - you should ask your midwife for a repeat swab. In countries that do universal screening (ie swab every pregnant woman to check) it is done at 35-37 weeks because we know that it can come and go from the genital tract, so you want the swab to be within around 5 weeks of birth. A repeat swab now may find that it is clear and then you don’t have to worry. Note also though that if it has been found in your urine earlier in the pregnancy then this is less likely to clear and you don’t need a repeat.

it sounds really scary when you google it because it can cause very serious infection in newborns, but you have to remember the level of risk to baby is really really low.
Antibiotics are recommended to reduce an already low risk, to even lower still.

If you weren’t wanting a CS for any other reason then I wouldn’t think you should change that plan on the basis of a tiny tiny risk. It’s a shame that you can’t have the antibiotics in a birthing unit (I’m not in the UK but I am surprised by this as it’s such a simple thing so seems like birthing unit should be capable!).

if you want to read detail about it from UK guidelines you could look at GBS Greentop guideline which you can find with a quick google.

I understand your concerns but definitely this isn’t something that needs to derail all of your plans or worry you too much. I had this in one of my pregnancies and didn’t need to change anything other than having a couple of doses of antibiotics.

I was gbs+ in my first pregnancy at about this time. Protocol for me was iv antibiotics for 4hours at start of labour and every 2? Maybe 3 hours after.
I didn't end up labouring for that long so didn't even get an hour of antibiotics in, baby kept in for 8 hours after delivery to ensure she didn't get infection, all was well
Baby 2 was automatic gbs+ protocol because I had it in the first, again 4hrs IV antibiotics which again, didn't get in time even going in extra early. Monitored for i hours post delivery. All was fine.
Both labours were natural and spontaneous.
Like pp's have said, it's incredibly common and mostly unaffects baby. It's just something that if baby gets can be very serious for them so they flag it and take precautions.

Its really common and is transient so comes and goes all the time. You could test positive and negative on and off your whole life. It lives in your gut and is mostly harmless to adults, but can make babies sick. That's why it's looked for in pregnancy. Even if you have untreated GBS in labour the risk of baby contracting it is low, but it's a risk best avoided by taking the IV antibiotics as those babies who do contract it can potentially get very sick. Not a reason for c section when it's so common and chances of a negative outcome low. There's no treatment to clear it in pregnancy unless its causing a UTI. IV antibiotics once your waters break/throughout labour are very effective. I had it detected on a rapid swab once my waters broke, had IVs throughout labour and asked for baby's obs to be checked on the ward as it was something that made me nervous. He was totally fine thank goodness.

Thanks all. For those that have been GBS+ did you have any symptoms? There is conflicting information when you google it. I feel like I’ve had thrush on and off this pregnancy but could this be from strep b instead? I guess it would make sense that the canestan I was prescribed didn’t clear my symptoms completely? TMI* I’m sore down there (it feels slightly swollen), have an unusual discharge and incredibly itchy.

Hi, can I please ask what led to the midwife doing swabs back in April? I'm 37+2 right now and haven't been asked to check for strep b. I'm planning to give birth at the birth centre too, and during the referral process the midwife asked if I had strep b and I said no, but I dont believe they've never checked for it specifically..?

I had it. Only knew with second child.
Injections were needed 4 hours apart- but things moved too quickly for that, so DD spent a little time being monitored afterwards.
I was still able to have a water birth. Had not noticed any symptoms.

@MK0411i was never swabbed, I think it was picked up in routine bloods both times. Although second was protocol under presumption before I'd even got results back.
So I'd safely assume if your midwife hasn't told you you're gbs+ then you aren't.
I'm sure somebody will correct me if im wrong though

@harleqabsolutely symptomless. Both times
I haven't had thrush in any other pregnancy (or during non pregnancy status) however did have it in this pregnancy, completely unrelated to gbs I think? And did completely clear up with one dose of something similar to canesten (different country and don't have this brand so used something with active ingredient of econazole nitrate)
If it keeps coming back, perhaps it's a reinfection from partner? (Ie passing it back and forth between you both) I'd suggest both you and him get treated, and /or see if somebody can perscribe a stronger med for it? Guessing on that last part, no idea if one is better than the other.

From what I can gather NHS don’t normally test for it only if it’s picked up from urine or a swab. At an appt in early April I had thrush like symptoms and she said to swab and test in case I needed antibiotics, no mention of strep b at the time, only now.

Strep B is intermittent so there is nothing to say that you have it now. It naturally occurs in the vagina and isn't an infection, just a type of bacteria. They haven't done much research on vaginal bacteria in labour but the bacteria changes so that it can give our baby the best gut bacteria. Accept antibiotics (when you don't even have an infection) and it will wipe out yours and your babies gut bacteria. They haven't done much research into the long term effects of this, but allergies, and lifelong conditions like Chrome's are all linked to not enough gut biome.

It is a precautionary thing that they do to prevent infection in the baby post birth. I think the statistic is that they have to give 7500 women antibiotics in order to catch one baby and prevent it from getting an infection. It's ridiculous. I would refuse the antibiotics if it was me. Especially as you might not even have the streb b any more.

@harleq @Hedgehogbrown I would read the actual stats here https://gbss.org.uk/info-support/about-group-b-strep/what-is-group-b-strep/
Rather than just a blanket 'don't accept antibiotics' statement. The effects of EOS GBS can be devastating. The babies who get sick, deteriorate fast. There is no reliable way of determining which babies will struggle and which won't.

A few days after my DS was born I had an infection turned out to be strep b. All I was told was if I was to have another child let them know that I had had it. I don't think they test for if here unless private. If any of my daughters become pregnant I will make sure they are tested for it

Hi OP. I had it detected during my first labour. I was then put on IV antibiotics in labour. I then ended up with an unrelated EMCS so they weren’t so worried about it in the end as my baby wasn’t born vaginal. They monitor babies born to women with it for 24 hours I believe.

With my second baby, I had a sticker on my notes front rage saying I had it previously. I was told I’d get swabbed in labour and my baby would be monitored. I ended up with an elective so again no worries about it.

It’s very common! All the best.

Front page* - sorry!

My ex partner had it and she was treated with prophylactic antibiotics for most of her pregnancy. Our baby’s delivery went without hitch and our beautiful baby is now 15 yrs old.