Group B Strep advice

[NoTeaForMe]

Hi all,

I had my routine tests done in early pregnancy and at about 9 / 10 weeks my doctor called me to talk about the results. As I was at work I couldn't call I have an infection in my cervix that showed up in my urine. He assured me that it would cause no harm to the baby but would need to be sorted before I go into labour. I asked if it was ok to wait till after 12 weeks as I wasn't keen on taking antibiotics before the magic 12 weeks. He told me this would be fine, as long as I took them before I went into labour he said it wouldn't matter.
I had my 12 week scan, all fine and had my 16 week check this week (Am now 17 weeks) and heard the heartbeat!! I mentioned the infection to my midwife (it was actually a temporary midwife as my midwife is on holiday....again!) who looked at my notes and phoned the lab to double-check them and she told me that I actually have Group B Strep.
I have googled this (dangerous idea!!) and found lots of worrying things out. Apparently this can cause miscarriage in early pregnancy, obviously I haven't miscarried but I am a bit annoyed that the doctor didn't advise me properly on this, I would never have waited over 2 weeks to take the antibiotics had I known what could have happened. My midwife says I will have to have the baby in hospital ( I was hoping for a midwife led birthing centre) and have IV antibiotics when I go into labour. I am not overly worried at the moment but do feel I am getting very conflicting advice. My doctor brushed it off, the midwife explained a bit more and the net tells me horror stories!
Anyway, is there anybody out there with personal experience of this? Is it a good thing that they caught it so early or does it not really make a difference? Would just be nice to hear from someone.

Sorry for the long post!

PS I have also read that it can cause premature labour and they wouldn't leave you too long after your waters breaking before inducing labour. Is this true? I have a close friends wedding I really want to go to which is only 5 days before my due date ( I completely understand that this might not happen regardless of the infection!) but if I am more likely to go onto premature labour and would need to go straight to hospital if my waters broke I am guessing I will never make the wedding?!

Haven't any personal experience but I did a fair bit of research when I was pg. Most useful site was this one, have you seen it?

www.gbss.org.uk/index.php

I think by far the biggest risk is that of the baby getting ill after the birth, but that risk can be dramatically reduced by giving IV ABs in labour As far as I know there is no need to give you ABs at the moment. I know it does all sound scary, but I'm sure it wil be fine, it's actually a very common thing and it's really good news that they are aware of it- most hospitals don't test in the UK.

Something like 30% of women carry GBS, and to the vast majority of babies born there is no problem.

I had IV antibiotics during my second labour for GBS and my dd2 was born fine. She was checked regularly after the birth and there were absolutely no problems. I had a natural water birth (at home) and the IV abs did not interfere with this.

There is no point in giving abs at the moment as the GBS can come back.

Hi noteaforme,the info you can find out about strep b is very scary,i was given a leaflet about it in hospital after they realised i had it after my dd was born,it totally freaked me out especially as they had confirmed that dd had it too. We were both fine though after both of us receiving antibiotics[nine days in hospital].
With dd2 i just went into hospital as soon as i went into labour as you need antibiotics at least four hours before the baby is born,we were both fine and came out the next day.
I'm 28wks pregnant with number 3 and will just have the antibiotics again,i did ask about a home birth and my midwife said i would have to have a large needle in my bum which is quite painful,anyway congratulations,try not to worry,at least they are aware of it x

first - is the GBS in your urine or from a vaginal swab? the 2 are diifferent.

if it is in your urine it is recommended you have a course of antibugs now and IV antibugs during labour.

if it is in your vagina it doesn't need antibiotics now but you should again have IV in labour.

once in labour you will be offered antibiotics every 4 hours until birth.

The biggest risk is early onset GBS in newborn. if you have cover in labour this reduces the risks of the baby developing this.

some info

Thanks for the replies, is there anyone out there with firsthand experience? Past or present?
EccentricGallumbits the infection showed up in my urine.

Hi there
First of all, don't stress yet. Much better to you know you're a carrier imho - lots of women don't even know about it and they don't routinely test for it.

I was a carrier of GBS and had DS in a MW led unit in a hosp with a consultant led bit down the corridor - so this is possible. My labour was actually q quick so I'm not sure I even got the full 4 hours of IV ABs and my DS was fine - they just kept us in for a bit longer for obs.

As for the wedding, babies do have a tendency of mucking up plans like that and as you say not much to do with the GBS

Anyway, Pozzled's link is your best bet for info (as well as MN obviously ) but best of luck with it - I'm sure you'll both be fine.

Hi Notea, I am a GBS carrier, I have two Dc and am pregnant with number three!

I had no idea I was a carrier with DC1, found out from a smear test and mentioned it when I was pregnant with DC2. As it can come and go at anytime I did a private GBS test (available via the internet and more reliable than NHS verion...my midwife advised me to do this!) at 38 wks and it came back negative. I decided to go ahead with a homebirth, it all went fine, monitered DC2 for the first 48hrs to check for signs of GBS and he was fine. I intend to do the same this time...

In the UK it varies area to area but most Midwife teams, from what I have read, will not administer AV ABs at home, which is a shame.

I did a lot of research, spoke to the head of midwives and the consultant obs at my local hospital and made an informed decision that was right for me.

this site is full of interesting points and so is GBS sight

The GBSS site that hackneyzoo linked is an excellent source of info.

I discovered I was a GBS carrier following a fall at 20 weeks. Freaked me out as I knew someone who lost their healthy newborn baby to GBS at two hours old.

Ds was born 7 weeks prem. Very very poorly (spent 25 days in hospital split pretty equally between NICU and SCBU - a real rollercoaster ride). I had iv antibiotics during labour. Ds had countless antibiotics too. He had every problem listed on the GBSS site for early onset GBS.

He is now a healthy 5 yr old but it was the most scary thing I have ever had to deal with and I thought I was prepared. Having said that it is pretty rare for babies to die from GBS or be seriously infected.

If in your urine RCOG guidelines recommend a course of antibiotics now (while pregnant) and IV antibiotics during labour.

EccentricGallumbits as I said in my original post I took a course of antibiotics after I had hit 12 weeks and had my scan. I wasn't questioning whether I needed the antibiotics, I was more upset that the doctor allowed me to wait a few weeks to take them when it is said that GBS can cause miscarriage.

Well you didn't miscarry and it's always best to avoid all medications during the first trimester so I'd say that's worked out quite well for you.

I completely agree belgo . I don't want people to think I am worrying over things that could have but didn't go wrong. I guess my slight concern with that is that I followed advice from my doctor but now I feel that he didn't properly explain the situation to me. My midwife is on holiday and I don't know when she is back, but she is VERY hard to get hold of even when she is not on holiday.
So I was looking for people who have been through or are going through a pregnancy with GBS to tell me that everything is ok! Also if it will affect my pregnancy and how. Also, although I will of course be taking the antibiotics in labour if that is what is recommended is that not a lot of medicine for a tiny baby? Are there side effects to all those antibiotics for the baby....or for me?

The important thing is that you KNOW. I found out I had it after a urine sample in my last pregnancy - I should have been given abs but wasn't . Now I am much more on top of it. Ds ws born at 35 weeks,but the swabs came back clear, so I don't think this was due to GBS. He had no problems at all due to GBS.

You can be tested at 35 weeks to see if you are carrying it at the time. (GBS comes and goes normally, so a negative test early on doesn't mean you'll be negative when you give birth and vice versa). HOWEVER because you had a positive test early on you will probably need antibiotics anyway.

You could look into being tested at 35 weeks. The lab I spoke to (The Drs Laboratory) said their tests stands for 5 weeks. You take a vaginal and rectal swab. i am going to get tested at about 32 weeks then again at 35 to cover me for going into prem labour again. Whatever result I get will be 'good'. if negative, I can ask about not getting IV antibiotics, and cn delay going into hospital. If positive at least I know and can make sure I get them etc.

THE MAJORITY OF PROBLEMS OCCUR WHEN THE MOTHER IS NOT KNOWN TO HAVE GBS. Please don't worry too much.

NoTea I think your best bet is to speak to your midwife when she gets back, or contact your Head of Midwives and express your concerns to her. I found so much conflicting advice on the internet about the postives of ABs and the negatives and whether there is any proof or their effectiveness or not. I think everyone has their own view points based on their own experiences and the best way forward is to do your research and speak to the health professionals you have available.

I found this article from the AIMS journal very informative too.

I hope the rest of your pregnancy goes well and think you are quite normal to worry, I had never heard of GBS either until the midwife matter of factly mentioned I had it!

Hi noteaforme

GBS is something the NHS and different hospitals keep changing thier policy on, so might be a reason for the mixed info you have.

As I was found to have GBS at end of last pregnancy I was told I'd need the IV in labour this time, but they've now decided I dont as they have testing me and the GBS has gone away. They wont test me again - as long as I dont get sick at all they;ll just assume I don't have it.

The IV is also just a dose every 4 hours in labour through a canula in your wrist - not constant drip feed.

Last time, as I tested positive for GBS 2 days before labour (but result came through the day after I gave birth as they have to grow the culture from the swab) I had to take my little one in for antibiotics and stay in hospital with her for a few days until her results came back clear. But aparantly if that happened today they don't do that anymore, they'd just make sure a closer eye was kept on her, to check she wasnt getting a temperature etc.

Hope that offers some assurance.

Perhaps you can request to be tested again closer to your due date - GBS does come and go.

MAin potentiale side effects of antibiotics:

Allergic reaction (which is why they like to give the IV abs in hospital so they can deal with the reaction)

Thrush infection - I got this. This can potentially be transferred to the baby and lead to difficulties breastfeeding if the baby was thrush in the mouth. I treated the thrush with canestan and my baby didn't get it.

Please try not to worry too much.

If you want a home birth it may be difficult in the UK because midwives generally don't administer IV abs at home (I'm in Belgium where the rules are different).

Apart from that you should still be able to have a hospital water birth if that is what you wish.

I was diagnosed with GBS after my trip to A&E with abdominal pains (not linked to GBS).
I was told my baby had to be born in hospital (wanted a home birth initially).

Labour started at 40+1 weeks.
My body temperature raised to 39, DD had passed meconium and was in distress.
DD's heart beat has been monitored continuously.
As I failed to dilate fast enough, emergency c-section was needed and DD had to be resuscitated.
We both had antibiotics, I had IV, DD had injections for 3 days.

As I had so many complications during those 24 hours, I am glad I was in hospital to start with.

Hi

I forgot to add that GBS can be passed on through hand contact, so it's worthwhile washing your hands beforeholding dc for the first 3 months. x

moonstorm - I have never heard that advice.

Of course it's worthwhile to wash hadns after using the toilet like you would usually do but I have never heard of the GBS being passed on to a three month old baby by not washing hands before picking up the baby.

Do you have a link to this advice?

I too have group B strep which was iscovered whilst i was in labour with my first child. He did not have any affects from it as he and i were given antibiotics during labour. With my second pregnancy i had GBS again and had my son in the midwife unit the labour was incredibly fast and there was no time to give him antibiotics. He got the infection and was treated over the next two days all the time we were in the midwife led unit. Now i have a very happy and healthy 17 month old little boy so try not to panic too much xxx

Half way down this page:

here

It says:

Handling your (or someone else?s) baby
Group B Strep may be carried on the skin, so everyone, whether they know they carry GBS or not, should wash their hands properly and dry their hands properly before handling a baby during its first three months of life. These are normal, good hygiene measures for a young baby, not GBS specific.

I should say it's from the GBS website.

hth