2003 Royal College of Obstetricians & Gynaecologists issue GBS guidelines

The Royal College of Obstetricians & Gynaecologists (RCOG) issued their Green Top Guideline No 36 “Prevention of early onset neonatal Group B streptococcal disease” in November 2003. GBSS’s original recommendations for GBS prevention have clearly been vindicated by this guideline – we advocated a similar approach over 7 years ago … but we hope a guideline advocating reliable testing will happen more quickly! The RCOG guideline quotes likely incidences of GBS infection based on the presence of recognised risk factors and recommends intravenous antibiotics in labour for women in higher risk groups. However, the guideline uses the minimum incidence figures quoted in the Heath et al paper and, therefore, not only underestimates the true incidence of GBS infection but, inevitably, also underestimates the risks to babies from GBS infection. GBSS is fully supportive of this guideline which, when fully implemented in the UK, will prevent the majority of lethal cases of GBS infection in newborn babies. The major difference between our position and RCOG’s is that we view their guideline as a key starting position as even more GBS infection in newborn babies could be prevented through adopting a testing approach to GBS prevention. Unfortunately, the tests currently used within the NHS to diagnose GBS colonisation are insufficiently reliable as they give a falsely negative result for up to 50% of carriers – reliable Enriched Culture Media (ECM) tests do exist but are not widely publicised and, at present, we know of only one London laboratory which offers these tests (see Test Now Available For GBS Colonisation below).