UK guidance about GBS
Group B Streptococcus (GBS) is a normal bacterium carried by 20-40% 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. Specific tests for detecting GBS carriage are increasingly being made available within the NHS, and are widely available privately (click here) from £35.
All pregnant women should be provided with an information leaflet about group B Strep – click here for the joint GBSS/Royal College of Obstetricians & Gynaecologists information leaflet
If you want to find out whether you are carrying group B Strep, the specific test to detect GBS carriage – the ‘ECM’ (Enriched Culture Medium) test – is not yet universally available within the NHS. Although group B Strep carriage may be detected when samples are taken for other reasons (for example, vaginal discharge), 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 miss a high proportion of women carrying GBS when the swabs are taken, though a positive result is reliable. ECM tests are available from those listed on our testing page; all of these follow UK Standards for Microbiology Investigations for detecting GBS carriage.
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 at regular intervals (usually 4-hourly) until your baby is born.
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.
In the UK, intravenous antibiotics are offered to women in labour to reduce the risk of their newborn baby developing group B Strep infection based on specific risk factors:
If you have had a baby who developed GBS infection, then UK guidelines from NICE and 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 (usually 4 hourly) until the baby is born.
If you carried GBS in your previous pregnancy, the Royal College of Obstetricians & Gynaecologists’ recommends that, since the chance of your carrying GBS in this pregnancy is around 50%, you should be offered the option of EITHER intravenous antibiotics in labour in your next pregnancy, OR the option of testing specifically for GBS carriage (using the sensitive ‘ECM’ (Enriched Culture Medium) test and then offered the intravenous antibiotics in labour if positive.
UK guidelines from NICE and 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 (usually 4-hourly) until the baby is born.
Urinary tract infections caused by GBS during pregnancy should be treated at the time of diagnosis in addition to your being offered intravenous antibiotics when you are in labour.
For more information about GBS detected in the urine, click here.
UK guidelines from NICE and 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 (usually 4-hourly) until your baby is born.
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.
The Royal College of Obstetricians & Gynaecologists recommends that you should be given intravenous antibiotics if you are in established preterm (before 37 weeks) labour and at regular intervals (usually 4-hourly) until your baby is born.
This is regardless of whether or not you are known to be carrying the bacteria.
The Royal College of Obstetricians & Gynaecologists recommends that:
If your waters break at term (37+ weeks of pregnancy) and you are known to carry GBS, you should be offered intravenous antibiotics immediately, with induction of labour as soon as reasonably possible.
If your waters break at term (37+ weeks of pregnancy) and you either don’t know whether you carry GBS or a test has been negative, you should be offered induction of labour immediately or expectant management up to 24 hours. Beyond 24 hours, induction of labour is appropriate.
If your waters break preterm (before 37 weeks) regardless of your GBS carriage status, intravenous antibiotics should be given once labour is confirmed or induced.
Intravenous antibiotics, given as soon as possible once labour starts, and at intervals (usually 4-hourly for penicillin) through until delivery has been shown to be highly effective at preventing group B Strep infection in newborn babies.
Not every pregnant Mum who has GBS detected during her pregnancy will want intravenous antibiotics in labour. Many will, and others will decide against having them either at all, or unless there are other additional risk factors. It’s important to discuss this with your midwife or doctor, or get in touch with us.
If you are allergic to penicillin or any other antibiotic, you MUST tell your healthcare professionals.
If you test positive for GBS and decide against antibiotics in labour, your newborn baby should be very closely observed by trained staff for at least 12 hours.
View our medical panel’s recommended approach to preventing GBS infection in newborn babies by clicking here.
We have worked with the Royal College of Obstetricians & Gynaecologists on a joint information leaflet about group B Strep for pregnant women and new parents. You can download the leaflet by clicking here.