Screening for Group B Streptococcus

Group B Streptococcus (GBS) is a bacteria found in the vagina of about 30-40% of the population of women.  It is not harmful to those that colonise it, but it has been shown to be a potential problem if newborn babies contract it during birth.  It is said that of all the GBS positive women, only about 1:200 babies will contract a GBS infection.  Some infections are mild, but some can lead to pneumonia, sepsis and death.

Some hospitals now screen all women for GBS at about 36 weeks.  If GBS is colonised, women are recommended to have antibiotics during labour, usually a penicillin based antibiotic.  If membranes rupture before labour, labour is often induced due to the fear of infection associated with GBS rather than giving the woman time to go into labour naturally.

A reasonably recent Cochrane review summarising the research findings surrounding Group B Streptococcus and maternal antibiotics in labour has shown that giving women antibiotics in labour who test positive for GBS is not reducing the incidence of GBS.  The review showed that there is not enough evidence to recommend giving GBS positive women antibiotics during labour to prevent early neonatal GBS infection.

Hospital policies need to be updated where women should no longer be screened for GBS, rather we should be treating all women who develop high risk symptoms, regardless of GBS status.  Some of these high risk symptoms are SROM >72 hrs once in labour, premature ROM, and premature labour.

Also, the risk of infection with a range of different organisms increases with vaginal examinations, and more specifically with the number of vaginal examinations performed.

Have a look at the Cochrane link below;

http://summaries.cochrane.org/CD007467/intrapartum-antibiotics-for-known-maternal-group-b-streptococcal-colonization

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