GBBS to treat or not to treat
- 0Mar 28, '11 by verockJust wondering...If a GBBS culture was done at 31-32 weeks and result was negative, and mom delivers at fullterm do your OB's usually treat w/ antibiotics? I was told that a culture this early can be a false negative? Thanks!
- 0Mar 28, '11 by Elvish GuideThe only reason we'd do a GBS on a mom that early is if there were a threatened preterm delivery. If negative, we'd probably retest at 36ish if she's still undelivered. If she comes back +, we'd probably go ahead and treat during labor, whether it occurred at term or before. And if she were a private pt, our private docs would probably treat her in subsequent labors too. I've seen plenty of women with a hx of +GBS be negative with in later pregnancies but that's their current protocol.
Honestly, though, I can't remember any scenario at my place that mirrors yours. If we have someone come in at term with unknown GBS, we don't treat. Preterm, the scenario changes a bit and it depends as much on who the doc is as anything whether they choose to treat.
I just attended a webinar on neonatal sepsis and the statistic the presenting neonatologist quoted was that somewhere around 80% of neonatal GBS sepsis cases are from infants whose mothers tested negative. So in the OP scenario it may not be a 'false negative' as much as a later conversion to positive.
- 0Mar 29, '11 by Hushi05
- 1Mar 29, '11 by Elvish GuideI don't know if it is still this way, but a Canadian nurse friend of mine told me that moms who were +GBS did not get treated; rather, they just watched the babies for sepsis. I find that interesting, because for all we know our term unknown GBS moms here are positive as well, and all we do is watch babies x 48hrs, no blood cultures.
Hopefully someone who works in Canada can clarify this for me.
My fear is that we treat people so often - and believe me, I understand why -that we are going to eventually end up with GBS that isn't susceptible to any of the current recommended treatment modalities.
- 1Mar 30, '11 by klone, BSN, RNQuote from tablefor9Oh, I hear you. Prior to my current job, I worked at a small community hospital with a very strong "Good Ole' Boy" network. The OBs were very old-school and did things their way because that's the way they were taught. Now I work at a very progressive place and there's NO WAY I could ever go back. I would probably get fired for constantly questioning the doctors and pi$$ing them off.Yep, klone, you're right. But, the wheels of change move slowly in OB units in the Deep South...we've only changed from NPO x ICE to clears in labor this last year, in this particular hospital.
We battle on.