What is Group B Streptococcus?
Most of us will not have heard of Group B Streptococcus (Group B Strep or GBS), yet it is a common type of bacteria carried by about one third of us without us usually knowing. It is one of a number of bacteria that normally live in our bodies.
Occasionally, however, GBS causes life threatening infections in 1 in every 1,000 babies born in the UK. Each year, 700 babies develop GBS infections (Septicaemia, Pneumonia, or Meningitis, 100 of these babies die, and 20 babies suffer long-term mental and/or physical handicaps, from mild learning disabilities to severe mental retardation, loss of sight, loss of hearing and lung damage. GBS is also a recognised cause of preterm delivery, maternal infections, stillbirths and late miscarriages.
BUT GBS CAN BE TESTED FOR AND INFECTIONS PREVENTED IN MOST CASES. Medical research estimates that testing, offering intravenous antibiotics to known GBS carriers and women in premature labour would prevent 80-90% of GBS infections in newborn babies in the UK. Testing for GBS saves lives!
How do I know if I carry GBS?
GBS does not make you feel unwell and there are no symptoms (there is no smelly discharge as some midwives claim). The only way to find out if you carry the GBS bacteria is to be tested for it.
The GBS test sometimes used by the NHS (often called an HVS) is not reliable. It give a false negative result half the time (it says you don?t carry GBS when you do!), although if you get a positive result from the HVS test this is accurate.
A reliable Enriched Culture Method (ECM) test is available privately. This test is much more sensitive and has been specifically designed to detect GBS. But the ECM test has only been available in the UK since May 2003 so many health professionals may not yet know of it, particularly as GBS testing is not standard procedure. The test is simply a swab.
There is only one laboratory in the UK that carries out the ECM test at this time, The Doctors Laboratory www.tdlplc.co.uk. You (or your health professional) can ask for a free GBS Screening Pack by calling 020 7460 4800 or e-mail them at [email protected]. There is a £28.00 fee when you return the test for analysis (some health professionals may also charge you for specimen collection). The results take 3 working days and will be sent to your health professional. For more details of the ECM go to ?How Can I Get an ECM Test? on the Group B Strep Support website www.gbss.org.uk. Because the swabs and the results are sent through the post, the test can be done anywhere in the country.
The ECM test is best done between 35-37 weeks. This is because the GBS bacteria comes and goes in your body. Any earlier, you might test negative only to have the bacteria appear nearer your due date. Any later and you might give birth before the result is back!
What if I test positive for GBS?
A positive test for GBS means the GBS bacteria was present at the swab was taken - NOT that you or your baby will become ill. Roughly 230,000 babies are born each year to women who carry GBS and, of these, only 700 develop GBS infection. Carrying GBS is perfectly natural and normal ? you just need to take precautions when giving birth. You should be offered intravenous antibiotics as soon as you go into labour or when your waters break, and then 4-hourly until delivery. A detailed leaflet ?For Women Who Carry GBS? can be downloaded from The Group B Strep Support website for you to hand to your midwife and/or obstetrician.
A negative ECM test result means you do not need to be offered intravenous antibiotics.
What if I can?t be tested?
Testing is not essential. If you have not managed to be tested (or the result is not available), or the less reliable NHS test has come back negative you should discuss with your midwife or obstetrician about your birth plan and being offered intravenous antibiotics if one or more risk factors is present. These risk factors are explained in the short ?GBS & Pregnancy 2 page summary? and more detailed ?GBS: The Facts? can be downloaded from The Group B Strep Support website for you to hand to your midwife and/or obstetrician.
If GBS is so rare, why should I be tested?
Many midwives, doctors, and obstetricians will tell you there is no need to have a test for GBS as it is so rare. Serious GBS infections in newborns are very rare, but testing for GBS will make the chances of your baby being affected even more unlikely IF you find out you are a carrier BEFORE you give birth. Pregnant women are routinely tested for several rare conditions ? HIV, syphilis, spina bifida, Hepatitis B. You are not being paranoid asking for a test ? just taking precautions for the healthy delivery of your baby. Not testing for GBS currently contributes to 120 babies dying or being disabled each year. Around 90 of which might have fully recovered had their mothers been tested for GBS in late pregnancy and given intravenous antibiotics before birth. As there is a simple, cheap test (that doesn?t cost the NHS a penny) that can prevent GBS infections why not take it?
Elective Caesarean sections
Elective Caesarean sections are not recommended as a method of preventing GBS infection in babies as a) they do not eliminate the risk of GBS to the baby as GBS can cross amniotic membranes (although they do reduce the risk), b) the recommended intravenous antibiotics in labour are highly effective and c) there are significant risks associated with Caesarean sections.
If you are having a caesarean there is no evidence to show intravenous antibiotics are beneficial against GBS when a woman known to carry GBS is having an elective Caesarean unless she is in labour OR her membranes have ruptured. And your baby would only need intravenous antibiotics if born prematurely or if there were signs of possible infection in either you or the baby.
If you are having an elective Caesarean AND you are also in labour or your waters have broken, you should be offered the recommended intravenous antibiotics, ideally for at least 4 hours before delivery. Again, your baby would only need intravenous antibiotics if born prematurely or if there are signs of possible infection in either you or the baby. If you feel particularly anxious and want intravenous antibiotics 4 hours before the operation, discuss this with your obstetrician. He/she may be prepared to give them to you.
Oral Antibiotics
There's no evidence that oral antibiotics during pregnancy, including late pregnancy, affect the likelihood or otherwise of a baby developing GBS infection. The only time when antibiotics have been proven to be effective at preventing early-onset GBS infection in babies is when they're given intravenously to the mother as soon as possible after the onset of labour or waters breaking at intervals until delivery.
Don?t have nightmares
Reading about GBS can be pretty worrying and can make you think ?what if ...? (and what ifs can drive us all to distraction). Do please remember that GBS are just one of a number of types of bacteria which normally live in our bodies without causing any symptoms and most babies are not affected by exposure to them. In the UK, approximately 700,000 babies are born each year, of these, 230,000 to mothers who carry GBS and, of which only 700 develop GBS infection. If you are found to carry GBS, this perfectly natural and normal ? you should just take the best possible protection for your baby, should they be susceptible, by having intravenous antibiotics during labour and delivery
My own story?
Two years ago our first baby was diagnosed with meningitis at only 18 hours old. The first time we?d ever heard of GBS was in Group B Strep Support leaflet handed to us by the midwife when our newborn daughter was on a ventilator fighting for her life in intensive care. Isabel survived, but the infection caused permanent brain damage leaving her blind with severe cerebral palsy. At 2 years of age she cannot roll, sit, crawl, stand, walk or even hold her own toys. To read in this leaflet that not only could I have been tested for GBS in the last month of pregnancy but, as an identified GBS carrier, that intravenous antibiotics during labour might have reduced the severity or even prevented her infection was, and remains, simply devastating.
I don?t want to frighten anyone, just reach the parents of that 1 in 1000 baby and spare them the heartbreak we went through with our baby daughter. I would gladly have paid £28 for her not be disabled.