Group B Strep in Pregnancy: Frequently Asked Questions
- What is Group B Strep (GBS)?
GBS is one of many common bacteria that live in the human body without causing harm in healthy people. GBS develops in the intestine from time to time, so sometimes it is present and sometimes it is not. GBS can be found in the intestine, rectum, and vagina in about 2 of every 10 pregnant women near the time of birth. GBS is NOT a sexually-transmitted disease, and it does not cause discharge, itching, or other symptoms.
- How Does GBS Cause Infection?
At the time of birth, babies are exposed to the GBS bacteria if it is present in the vagina, which can result in pneumonia or a blood infection. Full-term babies who are born to mothers who carry GBS in the vagina at the time of birth have a 1 in 200 chance of getting sick from GBS during the first few days after being born. Occasionally, moms can get a postpartum infection in the uterus also.
- How Do You Know if You Have GBS?
Five to three weeks before your due date, during a regular prenatal visit, you or your clinician will collect a sample by touching the outer part of your vagina and just inside the anus with a sterile Q-tip. If GBS grows in the culture that < is sent to the lab from that Q-tip sample, your clinician will make a note in your chart and you should be notified so you can share this information when you go into labor. Using the test results box printed on the back of this page will help you keep this record.
- How Can Infection from GBS Be Prevented?
If your GBS culture is positive within 5 weeks before you give birth, your clinician will recommend that you receive antibiotics during labor. GBS is very sensitive to antibiotics and is easily removed from the vagina. A few intravenous doses given up to 4 hours before birth almost always prevents your baby from picking up the bacteria during the birth. It is important to remember that GBS is typically not harmful to you or your baby before you are in labor.
- Do You Have to Wait for Labor to Take the Antibiotics?
Although GBS is easy to remove from the vagina, it is not easy to remove from the intestine where it lives normally and without harm to you. Although GBS is not dangerous to you or your baby before birth, if you take antibiotics before you are in labor, GBS will return to the vagina from the intestine, as soon as you stop taking the medication. Therefore, it is best to take penicillin during labor when it can best help you and your baby. The one exception is that, occasionally, GBS can cause a urinary tract infection during pregnancy. If you get a urinary tract infection, it should be treated at the time it is diagnosed, and then you should receive antibiotics again when you are in labor.
- How Will We Know if Your Baby Is Infected?
Babies who get sick from infection with GBS almost always do so in the first 24 hours after birth. Symptoms include difficult breathing (including grunting or having poor color), problems maintaining temperature (too cold or too hot), or extreme sleepiness that interferes with nursing.
- What Is the Treatment for a Baby with GBS Infection?
If the infection is caught early and your baby is full-term, most babies will completely recover with intravenous antibiotic treatment. Of the babies who get sick, about one in six can have serious complications. Some very seriously ill babies will die. In the large majority of cases if you carry GBS in the vagina at the time of birth and if you are given intravenous antibiotics in labor, the risk of your baby getting sick is 1 in 4,000.
- What If You Are Allergic to Penicillin?
Penicillin or a penicillin-type medication is the antibiotic recommended for preventing GBS infection. Women who carry GBS at the time of birth and who are allergic to penicillin can receive different antibiotics during labor. Be sure to tell your clinician if you are allergic to penicillin and what symptoms you had when you got that allergic reaction. If your penicillin allergy is mild, you will be offered one type of antibiotic, and if it is severe, you will be offered a different one.
The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JMWH suggests that you consult your health care provider. This page may be reproduced for noncommercial use by health care professionals to share with patients. Any other reproduction is subject to JMWH approval.
Journal of Midwifery & Women’s Health
Vol. 47, No. 6, November/December, 2002 495
© 2002 by the American College of Nurse-Midwives 1526-9523/02/$22.00
Issued by Elsevier Science Inc.
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