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July is Group B Strep
(GBS) Month |
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Group B
strep (GBS) is a bacteria naturally found in the digestive tract and
birth canal of 1 in 4 pregnant women. These women “carry” or are
“colonized” with GBS. However, GBS can come and go at any time so each
pregnancy can be different. Babies can be infected by GBS before birth
and up to 6 months of age because of their underdeveloped immune
systems.
GBS most commonly causes infection in the blood (sepsis), the fluid and
lining of the brain (meningitis), and lungs (pneumonia). It can cause
babies to be miscarried, stillborn, or die after being born. Some GBS
survivors have permanent handicaps such as blindness, deafness, mental
retardation, and cerebral palsy.
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Previous
Health Topics |
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HOW DO I KNOW IF I CARRY GBS? |
You may carry GBS with or without symptoms, such as vaginal
burning/irritation or unusual discharge. If you have symptoms, see your
doctor promptly for a bacterial culture test.
GBS can also cause bladder infections, with or without symptoms. Ask
your doctor to do a urine culture for GBS and other bacteria (not the
standard prenatal urine check.) GBS in your urine means that you are
heavily colonized, which puts your baby at greater risk.1 Oral
antibiotics should be prescribed.
It is now the standard of care in the USA and Canada for all pregnant
women to be tested for GBS at 35 to 37 weeks of pregnancy. Your doctor
will perform a swab test of your vagina and rectum and obtain the test
results in 2-3 days. If the test result is positive, you carry GBS. Ask
to make sure you are tested during each pregnancy!
Many hospitals now offer rapid, DNA-based tests such as the Xpert™ GBS
Assay (Cepheid, CA, USA). This test can be performed during labor or any
time during pregnancy with results in less than 1 hour.2 Rapid test
results are important because your GBS status can change by the time you
go into labor, culture tests can show a false negative, or your culture
test results may not be available. |
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HOW CAN I BEST PROTECT MY BABY
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...during pregnancy?
Ask your doctor to do a urine culture for GBS and other bacteria in at
least your first and third trimesters.9
See your doctor promptly for any symptoms of vaginal infection.10
Make sure you are tested at 35-37 weeks.
Avoid unnecessary, frequent, or forceful internal exams. Internal exams
can tell how far you are dilated, but do not accurately predict when
your baby will be born.5 (Vaginal ultrasounds may be available as a less
invasive alternative.3)
Talk with your doctor about not stripping your membranes or using
cervical ripening gel to induce labor. 4,6-8
Tell your doctor if you are allergic to penicillin. There are antibiotic
alternatives.1
Plan ahead if you have short labors or live far from the hospital. The
intravenous (IV) antibiotics you should receive in labor generally take
4 hours to be effective. 1
If you are having a planned C-section, ask to start IV antibiotics 4
hours before your incision. Your baby is still at risk if you have a
C-section.
Talk to your doctor about whether or not to use internal fetal monitors
during labor before you have had IV antibiotics for at least 4 hours.
Benefits may outweigh the risks.
...when my water breaks or I start labor?
Call your doctor.
If you tested positive for GBS, immediately go to the hospital to start
IV antibiotics.
If you do not have a GBS test result, and your hospital does not offer a
rapid DNA-based test such as the Xpert™ GBS test, you should be offered
IV antibiotics based on the following risk factors:
You have already had a baby with GBS disease.
You have had GBS in your urine during this pregnancy.
Your baby will be born before 37 weeks.
Your water has been broken 18+ hours without delivering. (Even 12+ hours
increases the risk.11)
You have a fever of 100.4 °F or higher during labor
In half of GBS infections, the mother has no risk factors.12 This is why
testing is so important!
...after my baby is born?
Antibiotics generally take 4 hours to be effective. If you give birth
before this, the hospital may culture and observe your baby for 48
hours.
You can ask for your baby to have antibiotics while waiting for the
results of the culture.
Some hospitals will give your baby a penicillin shot within 1 hour of
birth to further reduce the risk of GBS infection.1,14 Ask your doctor.
Have everyone wash their hands thoroughly before handling your baby.
Breastfeeding can supply your baby with important antibodies to fight
infection. 15 |
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WHAT GBS SYMPTOMS DO BABIES SHOW? |
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Take your baby to the emergency room or call your baby’s doctor
immediately if you notice these signs:
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High-pitched cry, shrill moaning,
whimpering
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Marked irritability, inconsolable crying
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Grunting as if constipated
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Projectile vomiting
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Feeds poorly or refuses to eat
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Sleeping too much, not waking for
feedings
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High or low temperature; hands and feet
may still feel cold even with a fever
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Blue, gray, or pale skin due to lack of
oxygen
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Blotchy, red, or tender skin
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Fast, slow, or difficult breathing
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Body stiffening, uncontrollable jerking
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Listless, floppy, or not moving an arm or
leg
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Tense or bulgy spot on top of head
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Blank stare
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For more information, visit Group B International |
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