group b strep in pregnancy

1. I don't know much about L&D nursing, only what I learned in school 6 years ago! But a friend who is pregnant (16 weeks at most) called me early this morning; she has tested positive for GBS. Can anyone tell me something about this? How common is it? Why was she tested so early for it? (did a bit of research myself, and usually reccomended testing 35-37 weeks.) Just because she is positive now, will that mean she is positive at delivery? Is this something you guys deal with frequently in L&D? Thanks for your input!
   
   Niccole
2. 

   About nmb

   Joined: Jul '02; Posts: 5

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3. 
   Oct 18, '02

   Occupation: LDRP-staff nurse Joined: Oct '02; Posts: 35

   At my facility, everyone is tested for GBS. The current recommendation is to test at 35-37 wks...the reason for this is that you could be negative early in the pregnancy and positive later in pregnancy...the early testing would miss those who become pos. later.
   We treat those who are positive with 600 mmu IVPB, then 300 mmu q4 hrs until delivery....once labor starts....we do not treat during the pregnancy.
   Our pediatricians keep mom and baby for 48 hrs, since most compications to the baby occur in the first hrs after delivery, if they are going to occur. But, complications are rare.
   There is a small risk for preterm labor with a positive GBS. But, most will not be treated for this threat unless they become symptomatic.
4. 
   Oct 18, '02

   Occupation: LDRP-staff nurse Joined: Oct '02; Posts: 35

   Let me clarify above post....we treat with 600 mmu Penicillin G, then 300mmu q 4 hrs....
5. 
   Oct 18, '02

   Joined: Apr '02; Posts: 38,756; Likes: 16,283

   Group-B strep is very common, colonized generally in the lower intestine and vagina/rectal area. While it can be present in many people as part of their normal flora, it can be DEADLY to neonates, who have no immunity to this bacterium, causing massive neonatal sepsis. It is NOT the same bacterium that causes STREP THROAT, (Strep-A), you must tell her. When this bacterium is found in other places, such as the uterus, it can also cause serious infection in adults.
   
   Usually, our ladies are tested later in pregnancy, (or if they show signs of or at risk of preterm labor), and if found to be carriers, are treated prophylactically with I.V. antibiotics----esp. if their water breaks or labor ensues. They are given antibiotics every few hours the duration of labor and the newborns are watched for s/s of group-B problems. Some doctors test patients early on in pregnancy (ours don't usually) and treat with P.O. antibiotics during pregnancy. The effectiveness of this is still debated, but is a standard of care for some. Our doctors treat ladies who were positive in prior pregnancies as positive once again in future labors.
   
   There are a lot of websites and bulletin boards regarding this very important subject.
   
   www.parentsplace.com has a board moderated by a very knowledgeable host and personal experiences are discussed here.
   
   Also there is the Group B Strep Association: www.groupbstrep.org is where you can find out more.
   
   You might want to refer this expectant mom to parentsplace, as they speak in laymen's terms that we all can understand, and with all the positive feedback I see there, she may find it comforting.
   
   She WILL be treated as POSITIVE in delivery, mark my words. That they tested now, means they must treat once positive. How they choose to is up to the doctors in her practice. We deal with this in labor/delivery VERY frequently, and there is no place I have heard of that does not treat aggressively while Mom is in labor and if a baby manifests ANY remote sign of Group-B infection. It is THAT critical. Good luck!

   Last edit by SmilingBluEyes on Oct 18, '02
6. 
   Oct 18, '02

   Joined: Oct '00; Posts: 10,236; Likes: 64

   Ummm.... what Debbie said.
   
   Heather
7. 
   Oct 18, '02

   Occupation: Nurse Joined: Aug '99; Posts: 364; Likes: 1

   We also treat our moms with antibiotics during labor if GBS positive. If the mother does not get two doses then we do a CBC and blood culture on the baby at 8 hours of age.
8. 
   Oct 18, '02

   Occupation: Level II Neonatal Nurse Joined: Oct '01; Posts: 76; Likes: 11

   We treat all mom that are GBS positive with penicillin or Cleocin. Babies get a CBC & blood culture on admission if mom is not treated 2 times with PCN (Q 4 hours), or treated once greater than 4 hours.
   My sister in law tested positive at 16 weeks also-- her OB treated with PO antibiotics also. She said it was to try to prevent miscarriage.
9. 
   Oct 19, '02

   Occupation: registered nurse Joined: Nov '01; Posts: 1,083; Likes: 14

   it is very common in our area, we treat with 2gm ampicillin initially then 1gm q4 hours till delivered. once patient tests positive they are always considered positive even with subsequent pregnancies.
10. 
    Oct 20, '02

    Occupation: L&D RN Joined: Aug '00; Posts: 425; Likes: 13

    all patients in community are tested **except large HMO groups' patients***
    
    all GBS+ treated w/ Amp or Penn or Cleo or Gent...
    preferably 2 doses

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