Information for Pregnant Women

Information for Pregnant Women 2017-03-22T09:39:43+00:00

Group B Streptococcus (GBS) is a normal bacterium which is carried by up to a third of adults, most commonly in the gut, and for up to 25% of women, in the vagina, usually without symptoms or side-effects. It is not a sexually transmitted disease.

In the UK, pregnant women are not routinely offered testing for group B Strep, unlike in many other developed countries.

Group B Strep carriage may be detected when samples are taken for other reasons – but often it’s not, because the widely used NHS test was not developed to find group B Strep and, unsurprisingly, is not very good at doing so. The standard ‘non-specific’ NHS tests give a high proportion of falsely-negative results, though a positive result is reliable.

Sensitive tests designed to detect group B Strep carriage are available, but rarely within the NHS. If you want to find out whether you carry group B Strep, the sensitive ‘ECM’ (Enriched Culture Medium) test is available from those listed at www.gbss.org.uk/test.  The ECM test is recognised as the ‘gold standard’ for detecting group B Strep carriage (click here to read Public Health England’s guidelines for this test).

It’s good to know if you carry group B Strep during your pregnancy so preventative action can be taken to minimise the chance of your newborn baby developing group B Strep infection.

If group B Strep is detected at any time during your pregnancy, you should be offered intravenous antibiotics from the start of your labour and regularly until your baby is born.

UK guidelines from NICE and from the Royal College of Obstetricians & Gynaecologists recommend that you should be offered intravenous antibiotics as soon as possible once labour starts and at regular intervals until the baby is born. This has been shown to be highly effective at preventing GBS infection in newborn babies.

View our medical panel’s recommended approach to preventing GBS infection in newborn babies click here

Treatment for GBS carriage (GBS detected from vaginal or rectal swabs) before labour starts is neither required nor shown to be beneficial, as no antibiotics tested so far have reliably eradicated GBS carriage.

UK guidelines from NICE and from the Royal College of Obstetricians & Gynaecologists recommend that you should be offered intravenous antibiotics as soon as possible once labour starts and at regular intervals until the baby is born. This has been shown to be highly effective at preventing GBS infection in newborn babies.

Urinary tract infections caused by GBS during pregnancy should be treated at the time of diagnosis in addition to your being offered intravenous antibiotics in labour

For more information about GBS detected in the urine, click here.

If GBS was detected before your current pregnancy, and you have not had a baby who developed GBS infection, it is not recommended for you to be offered intravenous antibiotics in labour unless either GBS is detected during this pregnancy or another risk factor is present. Carrying GBS in one pregnancy is not a reliable predictor of carrying it in another pregnancy, although you are more likely to be carrying it than if you’d not been found to carry it.

If you have had a baby who developed GBS infection, then UK guidelines from NICE and from the Royal College of Obstetricians & Gynaecologists recommend that you should be offered intravenous antibiotics in all future labours. These should be offered as soon as possible once labour starts and at regular intervals until the baby is born. This is highly effective at preventing GBS infection in newborn babies.

Not every pregnant Mum who has GBS detected during her pregnancy will want intravenous antibiotics in labour.  Many will, but others may decide not to have them unless there are other additional risk factors. Do discuss this with your midwife or doctor, or contact us.

If you decide against antibiotics in labour, it would be prudent for your newborn baby to be observed by trained staff for at least 12 hours.

Risk factors for group B Strep infection

Pregnant women carrying group B Strep is perfectly normal. GBS can be present at any time – in a woman’s first pregnancy, or in one or more subsequent pregnancies. It can be a threat during pregnancy, around delivery and afterwards. There are certain situations which increase the chance a newborn baby may develop GBS infection. These include::

  • Mothers who have previously had a baby infected with GBS – risk is increased 10 times
  • Mothers where GBS has been found in the urine at any time in this pregnancy – risk is increased 4 times
  • Mothers who have been shown to carry GBS in this pregnancy – risk is increased 3 times

The following clinical risk factors also increase the chance of a baby developing a GBS infection

  • Mothers who have a raised temperature* during labour of 37.8°C or higher – risk is increased 4 times
  • Labour starts or waters break before 37 weeks of pregnancy (i.e. preterm)  risk is increased 3 times
  • Waters break more than 18 hours before delivery  risk is increased 3 times

*A slightly raised temperature may be of less significance in a woman who has an epidural than in a woman who hasn’t.

Carrying GBS, combined with one or more clinical risk factor, increases the risk at least 9 times.

Carrying GBS during labour and delivery does not mean necessarily that you or your baby will become ill. The large majority of babies born to mothers colonised with GBS at the time of delivery will not develop GBS infection, even without preventative antibiotics in labour.

How much was this information worth?