During pregnancy, women are more susceptible to certain infections that pose risks to both the mother and the developing baby.

One such infection is caused by Group B Streptococcus (Streptococcus agalactiae), commonly known as Strep B or GBS. Understanding the risks, screening procedures, and prevention strategies related to GBS is crucial for ensuring a healthy pregnancy and minimising potential complications. To mark Group B Strep awareness month (July) we explore the key aspects of GBS in pregnancy and provide valuable insights for expectant mothers.

What is GBS?

GBS is a bacterium that can naturally reside in the vaginal or rectal area of healthy individuals without causing any harm. However, during pregnancy, there is a risk of transmitting this bacterium to the baby during childbirth, potentially leading to infections.

Risks to the Baby: If a newborn contracts GBS during delivery, it can result in serious complications such as pneumonia, sepsis, or meningitis. These infections can have long-term consequences for the baby’s health and development.

Screening for GBS: Screening for GBS is an optional test usually conducted between weeks 35 and 37 of pregnancy. The test involves a swab of the vagina and rectum, which is then sent to a laboratory for analysis. The results help healthcare providers determine the need for preventive measures during labour and delivery.

The National Institute for Clinical Excellence (NICE) produce national guidelines and recommend a risk-based approach for the prevention of early-onset GBS disease in newborns. This means that all pregnant women should be assessed for risk factors during pregnancy to determine whether they require additional preventive measures during labour and delivery.

  1. Identifying High-Risk Women: NICE guidelines suggest that the following factors should be taken into consideration when assessing a woman’s risk of transmitting GBS to her baby:
  • A previous baby with invasive GBS disease
  • GBS bacteriuria during the current pregnancy
  • GBS detected in urine during the current pregnancy
  • GBS detected from a vaginal swab during the current pregnancy
  • Preterm labour (before 37 weeks’ gestation)
  • Prolonged rupture of membranes (more than 18 hours)
  • Intrapartum fever (temperature of 38°C or higher)
  • GBS detected in a previous pregnancy.
  1. Antibiotic Prophylaxis: For women identified as high-risk, NICE recommends offering intravenous antibiotics during labour to reduce the risk of GBS transmission to the baby. The first-choice antibiotic is usually intravenous benzylpenicillin. However, alternatives such as intravenous clindamycin or erythromycin may be used if the woman is allergic to penicillin.
  1. Testing for GBS: Routine universal testing for GBS is not recommended by NICE in the UK. Instead, a risk-based approach is favoured to identify high-risk women. However, NICE advises testing for GBS carriage using vaginal and rectal swabs at 35 to 37 weeks of pregnancy for women who have one or more risk factors mentioned above.
  1. Intrapartum Antibiotics: For women with unknown GBS status or those who have not been tested, NICE recommends offering intrapartum antibiotics if any of the following risk factors are present:
  • Preterm labour (before 37 weeks’ gestation)
  • Prolonged rupture of membranes (more than 18 hours)
  • Intrapartum fever (temperature of 38°C or higher).

Prevention Strategies: To reduce the risk of transmitting GBS to the baby, healthcare providers may recommend intravenous antibiotics during labour. This preventive approach significantly lowers the chances of the baby developing an infection. It is essential to follow the healthcare provider’s advice and inform them of any potential risk factors or symptoms.

Risk Factors for GBS Infection: Certain factors increase the likelihood of GBS transmission during pregnancy. These include previous GBS infections (either in previous pregnancies or positive tests during the current pregnancy), preterm labour, prolonged rupture of membranes, or fever during labour. Understanding these risk factors can help identify high-risk pregnancies and implement appropriate preventive measures.

Signs and Symptoms: In pregnant women, GBS usually does not cause any symptoms or health issues. However, some women may experience urinary tract infections or other mild symptoms. It is important to consult with a healthcare provider promptly if any unusual symptoms arise during pregnancy.

Communication with Healthcare Providers: Open communication with healthcare providers is crucial during pregnancy. If you have concerns about GBS or any other health issues, discuss them with your healthcare provider. They can provide personalised guidance and address any questions or fears you may have.

GBS infection can be a concern during pregnancy, but with proper screening and preventive measures, the risks can be minimized. By understanding the importance of GBS testing, following the recommended preventive strategies, and maintaining open communication with healthcare providers, expectant mothers can ensure a safer and healthier pregnancy. Remember, early detection and timely interventions play a vital role in protecting both the mother and the baby from potential complications associated with GBS infection.

At RHL Solicitors, we understand that no one would wish to begin the long and emotional journey of claiming damages against the medical profession without good cause.

However, it’s crucial to ensure you get the expert legal advice and support you need. RHL Solicitors’s specialist medical negligence solicitors act for the victims of medical negligence, conducting thorough and rigorous clinical negligence investigations with the intention of establishing liability and recovering compensation.

When someone dies as the result of medical negligence, we are also able to act on behalf of the Deceased’s Estate and dependents to bring a claim. The expert reports we disclose to the Defendant during the claim process can also help to make a difference and to improve future care.

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