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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Has anyone given thought to Group B strep testing?

6 replies

sedgiebaby · 03/07/2010 09:07

NICE does not support routine testing although it would seem the rest of the western world does (I'm on another intl 'baby message board' and get this impression).

Any thoughts from anyone who has looked into this? I raised the question with my Consultant who said that they do not support testing (because of NICE guidelines) and he wouldn't bother if it was his wife, but if I do the test and it is positive they will treat me with antibiotics (hmmmm)

The risks are rare but potentially very severe for baby so as it is preventable I was going to pay for the test, any other thoughts?

more info here www.gbss.org.uk/

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japhrimel · 03/07/2010 09:17

If you have a test at 36 weeks even, it doesn't mean that you will have active GBS when you go into labour. It can come and go which is why routine testing isn't recommended - it's not a reliable test of who will be positive in labour.

Also, if you have a positive GBS test, you probably won't be able to have a home birth or water birth, even though lots of people who do have home and water births are probably positive without knowing. Home or water doesn't make it riskier, but most PCTs don't let you have the IV antibiotics at home or in a pool (even though this is very possible). So you're be very limited.

Add in that taking the antibiotics when you don't need them means you (and the baby) are just likely to get side effects (upset stomach, thrush, etc).

If you are GBS positive, then the GBS organisation advice is that you should have IV antibiotics if you also have another risk factor, e.g. fever in labour or early labour. If you don't have another risk factor, then they recommend that you should just be offered them, but the evidence for benefit isn't clear cut.

I've decided not to have private testing, but to make sure that both my OH and I know all the symptoms of GBS in newborns so we know when to rush the baby to the doctor and insist on antibiotics. Most GBS from labour will show in the baby, if they've caught it, in the first 12-48 hours after birth.

sedgiebaby · 03/07/2010 09:21

Thank you, I read a article about a lady whose baby was left brain damaged and blind and it worried me, that with so much that cannot be prevented/influenced here perhaps there was something I could.

And yet I wanted a water labour due to my SPD :S Also I don't know the symptoms I need to read some more about this I think.

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rainbowdays · 03/07/2010 20:32

sedgiebaby - there are NO symptoms.

This is taken directly from the GBSS website:
"GBS is a normal bacterium which is carried by up to 30% of adults, most commonly in the gut, but for up to 25% of women, in the vagina too."

"GBS can be present at any time - in a woman's first pregnancy, or in subsequent pregnancies. It can be a threat during pregnancy, around delivery and afterwards.

There are five recognised situations which increase the chance that a baby will be exposed to GBS, if susceptible, of developing GBS infection. Each of the risk factors shown panel below increases the risk of GBS infection in a newborn baby:

Mothers who have previously had a baby infected with GBS ? risk is increased 10 fold

Mothers who have been shown to carry GBS in this pregnancy or GBS has been found in the urine at any time during this pregnancy ? risk is increased 4 fold

Any of the following clinical risk factors ? risk of GBS infection is increased 3 fold for each

Labour starts or membranes rupture before 37 weeks of pregnancy is completed (i.e. preterm).
Where there is prolonged rupture of the membranes ? more than 18 hours before delivery.
Where the mother has a raised temperature* during labour of 37.8°C or higher.

*If a woman has an epidural, a slightly raised temperature may be of less significance than in a woman with no epidural.

Carrying GBS, combined with one or more clinical risk factor, increases the risk at least 12 times.

75% of early-onset GBS disease and 90% of resultant deaths follow deliveries with one or more of these risk factors.

About half of the babies born to mothers colonised with GBS at the time of delivery will become colonised themselves and, of these, only around 1 in 200 will develop GBS disease, even without any preventative medicine during labour. Carrying GBS during labour and delivery does not mean necessarily that you or your baby will become ill.

Simply carrying GBS previously, without a positive test result during the current pregnancy, does not mean a woman should be offered intravenous antibiotics in labour unless one or more other risk factors are also present.

Must I have intravenous antibiotics if I?ve had a positive result during this pregnancy?
If you have had any positive GBS test result from the vagina or rectum during the current pregnancy, you should be offered intravenous antibiotics from the onset of labour or membrane rupture until delivery. However, you may choose not to have them if there are no additional risk factors - only a small percentage of babies born to colonised mothers will develop GBS infection. However, if you decide against antibiotics, it would be prudent for the baby to be observed by trained staff for at least 24 hours (and ideally for 48 hours). If the positive test was from the urine, this means that the GBS was more invasive, and so antibiotics will be recommended even if a vaginal swab is subsequently negative. "

My personal experience is that I have been one of the lucky ones. I had two children and was not tested. When pregnant with my third child I was tested and found positive, but due to the speed of my labour, my son was born at home, no time for hospitals or antibiotics. I did watch him like a hawk for 48 hours, ready to rush to hospital if needed. But he was fine.

There are others on mn that have had babies with gbs at birth and have had them in scbu being treated. There are also women here who have lost there baby due to gbs.

So it is important to be informed of the risks, and of the extra things (like premature rupture of membranes) that increase your risk and increase the benefit of having antibiotics in labour.

For another website putting a different viewpoint on antibiotics in the case of GBS look at
this website, it does refer to homebirth an GBS but the information in it is helpful even if not considering homebirth.

It is an individual choise that needs to be made carefully. I hope that you are able to get all the information you need to make your own decision.

Lionstar · 03/07/2010 20:38

I tested positive for GBS at 37 weeks and still went on to have my planned homebirth. I didn't have IV antibiotics obviously, but it was all done with full support of my midwives. We did 2 hourly obs on DS for 24 hours afterwards.

I didn't do this lightly BTW, I had the test done privately just so that I was fully informed and had my eyes wide open. I did lots of research following the positive, rainbowdays gives a very good summary of the issues and main points of risk. As others have pointed out, as GBS is so prevalent there will be many homebirths where it is present and the vast majority of those have happy outcomes.

japhrimel · 04/07/2010 10:04

There are symptoms of active GBS in newborns that you can learn about so as to know all the warning signs.

sedgiebaby · 04/07/2010 20:46

Thank you for all of this info, I will take the time to properly read these posts and the links, Thanks very much both

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