Information for Pregnant Women

Information for Pregnant Women 2017-09-15T11:52:42+00:00

Group B Streptococcus (GBS) is a normal bacterium carried by up to a third of adults, most commonly in the gut, and for up to 25% of women in the vagina, usually with no symptoms or side-effects. It is not a sexually transmitted disease.

In the UK, all pregnant women are not routinely offered testing for group B Strep carriage, unlike in many other developed countries. Sensitive tests for GBS carriage are not widely available within the NHS, though they are available privately (click here) from less than £40.

If you want to find out whether you carry group B Strep, the test specifically to detect GBS carriage – the ‘ECM’ (Enriched Culture Medium) test – is not yet widely available within the NHS. Although group B Strep carriage may be detected when samples are taken for other reasons, the ‘general purpose’ tests were not developed to find group B Strep and, unsurprisingly, are 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. The ECM tests are available from those listed at www.gbss.org.uk/test, all of which follow Public Health England’s guidelines for ECM testing.

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 current pregnancy, you should be offered intravenous antibiotics from the start of your labour and regularly until your baby is born.

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.

If you carried GBS in a previous pregnancy, a new recommendation in the September 2017 Royal College of Obstetricians & Gynaecologists’ GBS guideline is that you should be offered the option of EITHER intravenous antibiotics in the subsequent labour OR testing specifically for GBS carriage (using the sensitive ‘ECM’ (Enriched Culture Medium) test and being offered the intravenous antibiotics in labour if positive.

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.

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.

A new recommendation in the Royal College of Obstetricians & Gynaecologists updated GBS guideline published in September 2017 recommend that you should be offered intravenous antibiotics if you are in established preterm (before 37 weeks) labour and at regular intervals until the baby is born. This is regardless of whether you are known to be carrying the bacteria or not.

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.

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 get in touch with us.

If you decide against antibiotics in labour, your newborn baby should be very closely 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.

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