Help protect your baby from Group B strep( GBS):

Supriya Rao MD

July is Group B strep International awareness Month . Group B strep is the leading cause of sepsis and meningitis in the newborn.

What is Group B Streptococcus?

GBS is one of the many bacteria that live in the body and doesn’t cause any serious illness. It is found in the digestive, urinary and reproductive tracts of men and woman. In woman it can be found in the vagina and rectum. It is not a Sexually transmitted disease.

About 1 in 4 pregnant woman carry or are colonized with GBS .Unfortunately, babies can be infected by GBS before birth and up to about 6 months of age due to their underdeveloped immune systems. Only a few babies who are exposed to GBS become infected, but GBS can cause babies to be miscarried, stillborn, or become very sick and sometimes even die after birth.

GBS most commonly causes infection in the blood (sepsis), the fluid and lining of the brain (meningitis), and lungs (pneumonia). Some GBS survivors have permanent handicaps such as blindness, deafness, mental challenges, and/or cerebral palsy.

Fortunately, more than 90% of GBS infections that develop at birth can be prevented if women who have tested positive receive at least 4 hours of IV antibiotics just prior to delivery.

How do I know If I carry GBS?

It is now the standard of care in the USA and several other countries for all pregnant women to be routinely tested for GBS at 35–37 weeks of each pregnancy (unless already positive in their urine in current pregnancy.) Your provider will perform a swab test of your vagina and rectum and obtain the test results in 2–3 days. If the test result is positive, you carry  GBS.

How can GBS infect my baby?

• GBS can infect your baby even before your water breaks. GBS infections before birth are called “prenatal-onset.”

• GBS can cause preterm labor, causing your baby to be born too early.

• GBS infection can also cause your water to break prematurely without labor starting.

• GBS infections within the first week of life are called “early-onset”. Most common problems caused by early infection are lung/blood and meningeal infections.

• GBS infections after the first week of life are called “late onset. “Sign and symptoms of late onset infection are:

-slowness or inactivity, poor feeding, fever, irritability and vomiting.

How can I help protect my baby ?

…during pregnancy :

-Ask to have a urine culture for GBS and other bacteria done at your first prenatal visit.

-See your provider promptly for any symptoms of vaginal infection.

- GET TESTED for GBS at 35–37 weeks. If the test result is positive, you should receive IV antibiotics when labor starts or your water breaks.

- Get a copy of all culture test results and keep them with you!

-Tell your provider if you are allergic to penicillin. There are IV antibiotic alternatives.

-Ask your provider to not strip your membranes if you test positive for GBS.

 …when my water breaks or I start labor?

-Call your care provider. Remind him or her of your GBS status.

-If you have already had a baby with GBS disease or have had GBS in your urine in this pregnancy, you should receive IV antibiotics regardless of this pregnancy’s GBS test results. Report any fever.

-Go to the hospital immediately if you should receive IV antibiotics. Have all test results with you. Tell the nurses that you need to start IV antibiotics for GBS.

-If you do not have a GBS test result, and your hospital does not offer a rapid GBS test, per the CDC guidelines you should receive IV antibiotics based on the following risk factors:

• Your baby will probably be born before 37 weeks.

• Your water has been broken 18+ hours without delivering.

• You have a fever of 100.4 °F or higher during labor.

In half of GBS infections, the mother has no risk factors. This is why testing is so important!

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