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What is Group B Streptococcus (GBS)?
Group B Streptococcus (GBS) is a type of bacteria commonly found in the intestines and lower reproductive tract. While it is typically harmless in most healthy adults, GBS can sometimes cause infections in mothers during pregnancy, labor and delivery, and the postpartum period. Rarely, GBS causes infection in individuals who have reduced immunity.
​Maternal Risk Factors for GBS Infection
Though GBS is more commonly discussed in the context of neonatal sepsis and meningitis, infections can occur in the postpartum period. Risk factors include:
  • GBS Colonization during Pregnancy: It is generally felt that women who were carriers of GBS during pregnancy are at a higher risk for postpartum infections due to GBS.
  • Had a C-Section: Women who undergo cesarean deliveries may have a higher risk of infection, including from GBS. Antibiotic prophylaxis is now routinely given and suppresses GBS. 
  • Experienced Prolonged Labor: Longer labors or prolonged periods of membrane rupture can increase the risk of bacterial infections.
  • Have Other Health Conditions: Conditions like diabetes or a compromised immune system can increase susceptibility to infections.​
Types of Maternal GBS Infections
Maternal GBS infections can occur during pregnancy, labor and delivery and the postpartum period. These infections can include:
  • Maternal Sepsis: Maternal sepsis is a severe and potentially life-threatening condition that arises from an infection during pregnancy, childbirth, or the postpartum period. Characterized by systemic inflammation and multi-organ dysfunction, it represents a major cause of maternal mortality and morbidity worldwide. Early recognition and intervention are crucial, as the condition can rapidly progress from mild symptoms to severe shock. The primary management strategies include prompt administration of broad-spectrum antibiotics, supportive care, and addressing the underlying infection. Despite advances in treatment, sepsis remains a significant challenge due to its complex pathophysiology and the variability in clinical presentation. Continued research and improved medical protocols are essential to enhance early detection and treatment outcomes for affected women.​
  • Postpartum Endometritis: Postpartum endometritis is an infection of the endometrium, the lining of the uterus, after childbirth. This condition often develops within the first few days to weeks following delivery. Symptoms can include fever, pain, and unusual vaginal discharge, which may be foul-smelling or abnormal in color, as well as infection of the fallopian tubes and ovaries. The infection can arise from bacteria entering the uterus during or after labor, especially if there was prolonged labor, prolonged period of membrane rupture, or a cesarean section. Prompt treatment with antibiotics is crucial to manage the infection and prevent complications, such as spread of infection.​
  • Wound Infections: ​Wound infections refer to infections that develop at the site of a cesarean section (C-section) or an episiotomy, which is a surgical cut made in the vaginal area to aid childbirth. These infections may lead to redness, swelling, and discharge at the affected site. The infection may occur if bacteria enter the wound due to factors such as prolonged labor, or complications during the delivery. Prompt treatment with antibiotics and proper wound care are essential to manage the infection, reduce inflammation, and prevent further complications. Ensuring good hygiene and regular monitoring of the wound site are key to preventing and addressing these infections effectively.
  • Urinary Tract Infections (UTIs): GBS is a common cause of UTIs, which may cause pain during urination, frequent urination, or rarely pyelonephritis, which is a kidney infection that occurs when bacteria from a UTI spread from the bladder to the kidneys. UTI’s may occur before, during and after pregnancy. 
Signs and Symptoms of Postpartum GBS Infection
​General signs of a postpartum GBS infection are similar to other bacterial causes of infection and may include:
  • Fever or Low Temperature: Especially if accompanied by other symptoms like abdominal pain or unusual discharge
  • Abdominal Pain: Persistent pain can be a sign of infection
  • Unusual Discharge: Foul-smelling or abnormal discharge from the vagina
  • Wound Redness or Swelling: At the site of a cesarean section or episiotomy
  • Painful Urination: Indicative of a urinary tract infection
Diagnosis and Treatment
If you suspect you may have any maternal infection, it's crucial to contact your healthcare provider promptly. Diagnosis typically involves:
  • Physical Examination: To check for signs of infection.
  • Laboratory Tests: Such as blood tests or cultures from wound sites or the urinary tract
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Treatment usually involves antibiotics to address the specific type of infection. Your healthcare provider will determine the most appropriate medication based on the infection's location and severity.
Preventive Measures
While it may not be entirely possible to prevent postpartum GBS infections, you can take steps to reduce the risk:
  1. Follow Prenatal Care Guidelines: Ensure that GBS is managed appropriately during pregnancy and labor.
  2. Maintain Hygiene: Keep the perineal area clean and dry, and follow proper wound care if you have had a cesarean section or episiotomy.
  3. Monitor for Symptoms: Be vigilant about any signs of infection and seek prompt medical advice if they occur.
  4. Follow Up with Your Healthcare Provider: Attend all postpartum check-ups and discuss any concerns or symptoms you may be experiencing.
Maternal GBS Story
Deb Haine Vijayvergiya’s story | Deb is a speaker, writer, non-profit founder, bereaved parent, and maternal health advocate who was severely infected by GBS when her first daughter was born.
Conclusion
Group B Streptococcus infections in postpartum women are uncommon but can occur, particularly in certain high-risk situations. Prompt recognition and treatment are essential for effective management and recovery. If you have any concerns about any possible postpartum infection, including those related to GBS, consult your healthcare provider for diagnosis and support.