Early-onset GBS Disease
“Prevention is better than cure.” – Desiderius Erasmus
GBS infections which occur within the first week of life are called “early-onset” GBS disease. It is currently the only type of GBS that has a recommended prevention strategy. Many countries recommend that all pregnant women should be screened for GBS (“universal screening”) and, if positive, given IV antibiotics during labor and delivery to help prevent early-onset GBS disease.
Ideally, your provider should do a urine culture for GBS and other bacteria at the first prenatal visit. GBS in your urine means that you are likely heavily colonized vaginally. If your urine tests positive, your provider should consider you as “GBS colonized” for this pregnancy.
It is now the standard of care in the USA for all pregnant women to be routinely tested for GBS with a vaginal/rectal swab test during the 36th or 37th week during each pregnancy unless their urine already cultured positive in the current pregnancy. This test is a culture of a swab that has been inserted in both the vagina and rectum. Inform your healthcare provider if you are using antibiotics and/or vaginal medications which may cause false negative results. GBS is a transient bacteria which means that a woman could test negative, but be colonized later in pregnancy and vice versa, but the results are considered to accurately (95%-98%) predict a woman’s colonization status at delivery if she delivers within 5 weeks of her test.
If your urine or swab tests are positive, your provider should consider you as “GBS colonized” for this pregnancy so that you receive IV antibiotics for GBS when labor starts or your water breaks. Plan ahead if you have short labors or live far from the hospital. The IV antibiotics you receive in labor generally take 4 hours to be optimally effective.
C-sections may not completely prevent GBS infection although, according to ACOG, the risk of early-onset infection for a full term baby during a planned C-section is extremely low if performed before your labor starts and before your water breaks.
If you do not have a GBS test result, and your hospital does not offer a rapid GBS test, per the ACOG guidelines you should be offered IV antibiotics based on the following risk factors:
Make sure you can recognize the signs of infection in your baby once he or she is born. If any signs are recognized, contact your care provider immediately!
Ideally, your provider should do a urine culture for GBS and other bacteria at the first prenatal visit. GBS in your urine means that you are likely heavily colonized vaginally. If your urine tests positive, your provider should consider you as “GBS colonized” for this pregnancy.
It is now the standard of care in the USA for all pregnant women to be routinely tested for GBS with a vaginal/rectal swab test during the 36th or 37th week during each pregnancy unless their urine already cultured positive in the current pregnancy. This test is a culture of a swab that has been inserted in both the vagina and rectum. Inform your healthcare provider if you are using antibiotics and/or vaginal medications which may cause false negative results. GBS is a transient bacteria which means that a woman could test negative, but be colonized later in pregnancy and vice versa, but the results are considered to accurately (95%-98%) predict a woman’s colonization status at delivery if she delivers within 5 weeks of her test.
If your urine or swab tests are positive, your provider should consider you as “GBS colonized” for this pregnancy so that you receive IV antibiotics for GBS when labor starts or your water breaks. Plan ahead if you have short labors or live far from the hospital. The IV antibiotics you receive in labor generally take 4 hours to be optimally effective.
C-sections may not completely prevent GBS infection although, according to ACOG, the risk of early-onset infection for a full term baby during a planned C-section is extremely low if performed before your labor starts and before your water breaks.
If you do not have a GBS test result, and your hospital does not offer a rapid GBS test, per the ACOG guidelines you should be offered IV antibiotics based on the following risk factors:
- Your baby will 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.
- You were GBS colonized in a previous pregnancy.
Make sure you can recognize the signs of infection in your baby once he or she is born. If any signs are recognized, contact your care provider immediately!
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Countries that have implemented universal screening for GBS colonization during pregnancy include Canada, United States of America, Argentina, Spain, France, Belgium, Germany, Switzerland, Czech Republic, Poland, Slovenia, Hong Kong, and Japan as well as regions of Italy and Australia.
Efforts are being made worldwide to implement better GBS care in all countries. Please share country-focused resources and articles with GBSI at info@gbs-intl.org. |
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