What To Know About Group B Strep During Pregnancy
No mom-to-be wants to find out she has any type of infection while shes pregnant.
So if youve just found out that youre group B Strep positive, or if youve simply heard of this condition and worry you may be at risk, you likely have a slew of questions and concerns about what this diagnosis means and what the risks are for you and your baby.
We have the answers to all of your questions and the information that will put your mind at ease.
Treating Gbs Infection In Adults
Early recognition and treatment is important to cure GBS infection in adults. High doses of antibiotics such as penicillin should be administered and the full course taken.
Most GBS infection can be treated successfully, although some people will require all the expertise of intensive care facilities. Not all hospitals have such a facility and so some ill patients will have to be transferred to one with these specialised facilities.
GBS infections, especially the more deep-seated ones, require expert care, prolonged courses of antibiotics and sometimes more than one antibiotic at the same time. In some cases, surgery may be necessary to drain infected sites and remove damaged tissue. Due to the varied nature of these infections, it is impossible to generalise about what is the most appropriate treatment.
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When I tested positive for GBS with my third child, I took everything I’d learned from my previous pregnancies, talked with a number of midwives, devoured information from professional publications, and came up with a few ways I trusted to treat my GBS naturally.
Before we go on, I must remind you: I am not a medical professional and what follows is how I treat my own GBS pregnancies and is not to be construed as medical advice. All good? Fabulous.
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What Is The Outcome
Although GBS infection can make your baby very unwell, early treatment means that most babies will recover fully. However about 1 in 20 babies who develop early-onset GBS infection will die and 1 in 14 of the survivors will have a long-term disability.On average in the UK, every month:
- 43 babies develop early-onset GBS infection.
- 38 babies make a full recovery.
- 3 babies survive with long-term physical or mental disabilities.
- 2 babies die from their early-onset GBS infection.
If you have had a baby affected with GBS infection there is an increased risk that any future baby will also be affected. This is why you will be offered antibiotics during labour if you have had a previous baby with GBS infection.
Further reading and references
- Next Review 18 February 2023
- Document ID 31194
How Is Group B Streptococcal Infection Diagnosed
GBS infection can be diagnosed from blood, urine or spinal fluid samples. The symptoms you have will influence which tests your doctor may ask for.
GBS can cause serious infections in newborn babies, and it is recommended that pregnant women are tested for GBS around the 36th week of pregnancy since carriers of the bacteria dont generally know they are a carrier until they are tested.
If you are likely to give birth early, your doctor may recommend you have a GBS test earlier on in your pregnancy.
A vaginal swab and sometimes an anal swab is used to obtain a sample which a lab then examines for GBS bacteria. You can do this test yourself at home or at the doctors clinic, or you can ask your doctor or nurse to do the swab for you if you prefer.
If you test positive while pregnant, your baby will need to be monitored in hospital for signs of GBS infection. This includes regular checks of the babys breathing, heart rate and temperature for at least 24 hours after they are born. If they show signs of GBS infection, your doctor will recommend a blood test and maybe other tests too, depending on the babys symptoms. These other tests could include a chest x-ray or a lumbar puncture of the babys spine.
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If I Am Gbs Positive And I Dont Get The Iv Antibiotics For Some Reason What Kind Of Tests Will My Baby Need To Have
As long as your baby appears to be doing well and you did not have any additional risk factors , then there is no need for your baby to have any special testing. There are some situations where the CDC recommends that a well-appearing infant have some blood tests. The CDC also recommends 48 hours of observation for infants who are born to GBS positive mothers, but there is no need to separate mom and baby for this observation period. To see the CDCs flow-chart with more details about newborn testing and observation, click here.
In The United States:
In 2010, the U.S. Centers for Disease Control and Prevention recommended universal screening for GBS at 35-37 weeks and in-labor antibiotics for all women who test positive.
These recommendations are supported by the:
- American Congress of Obstetricians and Gynecologists
- American Academy of Pediatrics
- American Academy of Family Physicians
- American Society for Microbiology
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Preventing Group B Strep From Infecting Your Baby
If your group B test at 35 to 37 weeks was positive, or if you have the risk factors listed above, your doctor or midwife will probably recommend that you have intravenous antibiotics when your waters break or labour starts.
Often this is penicillin, but alternatives are available if you are allergic to penicillin. The antibiotics pass through the placenta and into the baby. This greatly reduces your baby’s chances of becoming ill.
There’s no need for antibiotics before a planned caesarean because the baby will not pass through the vagina. You can’t pass the bacteria to your baby through the placenta.
Onset Of Group B Streptococcal Infection In Babies
The two types of GBS disease that affect babies include:
- early-onset the newborn shows signs of illness shortly after birth or within one to two days of birth. Early-onset GBS disease is the most common type
- late-onset infants show signs of illness one week to several months after birth. This form of GBS disease is comparatively rare. Only around half of all babies with late-onset GBS disease contract the illness from their infected mothers. For the remainder of cases, the source of infection is unknown.
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Reduce Or Eliminate Your Intake Of Sugar
Sugar helps bacteria and yeast grow and thrive, so eliminating it from your diet will help quell the growth of the streptococcus bacteria. This is one time when the type of sugar doesn’t really matter sugar is sugar when it comes to how well it helps bacteria grow. Obviously, I recommend sticking with natural sugars as much as possible, but reduce your sweets as much as possible.
When Do You Get Tested For Group B Strep
The Centers for Disease Control and Prevention recommends routine screening for group B strep in all pregnancies. You’re screened for GBS between 36 and 37 weeks of pregnancy. Group B strep testing involves your provider taking a swab of your vagina and rectum and then sending it to a lab for analysis.
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What If I Test Positive For Gbs
If you test positive for GBS or have any of the above conditions, you will be treated with intravenous antibiotics when you go into labour, or if your water breaks early. Although it is rare, your baby will still be monitored closely for symptoms of an infection. An infection may show up in the first 7 days, or after that. The early-onset type of infection can be very serious, and this is why GBS-positive women are treated during labour. If your baby shows signs of GBS infection, he or she will be treated with antibiotics.
Can You Be Tested For Gbs In Pregnancy
GBS is sometimes found during pregnancy when you have vaginal or rectal swabs or a urine test.
If GBS was found in a previous pregnancy but your baby was unaffected then there is a 1 in 2 chance that you will be carrying GBS in any future pregnancy. You should be offered a ECM swab test between 35 and 37 weeks of pregnancy to see whether you are carrying GBS.
In the UK, the NHS does not routinely offer all pregnant women screening for GBS.
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Carrying Group B Strep
Group B Streptococcus is a normal bacterium which is carried by 20-40% of UK adults, most commonly in the gut and in women in the vagina. Carrying group B Strep is usually without symptoms or side-effects.
Carrying GBS is perfectly normal and natural whether you are pregnant or not. Carrying GBS does not need treatment. GBS is not a sexually transmitted disease. Carrying GBS is not a disease at all.
A positive rectal or vaginal swab result for GBS means the person is carrying GBS at the time the samples were taken not that they are ill.
If Youve Had Gbs In A Previous Pregnancy
If you have had GBS in a previous pregnancy and your baby was not affected by GBS, you may be offered a test. This is because there is a 1 in 2 chance that you will be carrying it again in this pregnancy. You can have a swab test to see whether you are carrying GBS when you are 35-37 weeks pregnant.
If the result shows that you are still carrying GBS, the risk of your baby developing an infection is around 1 in 400. You will be offered antibiotics in labour.
If you are not still carrying GBS, then the risk of your baby developing an infection is much lower . You may still be offered antibiotics, but you may choose not to have them.
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Pearls And Other Issues
- In the United States of America, GBS is known to be the most common infectious cause of morbidity and mortality in neonates.
- Intrapartum antibiotic prophylaxis is only effective in the prevention of early-onset GBS infection.
- The CDC recommends universal screening with GBS rectovaginal culture between 35 to 37 weeks in each pregnancy.
- Intrapartum antibiotic prophylaxis is recommended with positive GBS rectovaginal culture, GBS bacteriuria at any time during the pregnancy, or a history of delivery of infant affected by early onset GBS infection.
- If GBS status is unknown, antibiotic prophylaxis is recommended during preterm labor and delivery , in the presence of maternal fever during labor, or with prolonged rupture of membranes .
- Intravenous Penicillin G is the antibiotic of choice for intrapartum prophylaxis.
- Additional options for antibiotic prophylaxis are ampicillin, cefazolin, clindamycin, or vancomycin.
Diagnosis And Treatment For Group B Streptococcal Infection
GBS infection is diagnosed from specimens collected from blood, urine or spinal fluid. Vaginal swabs may be collected from pregnant women to determine if they are asymptomatic carriers of these bacteria. The principal form of treatment for GBS is intravenous antibiotics, usually given in hospital. If the bacteria are found in a pregnant woman, intravenous antibiotics are given during the labour.
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How Do You Get Group B Strep
GBS bacteria naturally occur in areas of your body like your intestines and genital and urinary tracts. Adults can’t get it from person-to-person contact or from sharing food or drinks with an infected person. Experts aren’t entirely sure why the bacteria spreads, but they know that its potentially harmful in babies and people with weakened immune systems.
Can Group B Streptococcal Infection Be Prevented
GBS infection cannot be prevented entirely, but you can reduce the risk of passing an infection to your baby during birth by receiving antibiotics shortly before. Pregnant women should be tested for GBS before they go into labour so they can receive the antibiotics in hospital.
The antibiotics are delivered from an intravenous drip through a vein in your arm or hand. This way, the medicine travels through your body to your baby before they are born, helping to prevent infection in the first few days of life. The antibiotics should be given at least 4 hours before your baby is born.
If your baby is born by caesarean section , whether planned or unplanned, you do not need antibiotics for GBS. You may be offered other antibiotics as part of the routine care after surgery.
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Group B Strep And Pregnancy
Group B Streptococcus is a type of bacteria which lives in the intestines, rectum and vagina of around 2-4 in every 10 women in the UK . This is often referred to as carrying or being colonised with GBS.
Group B Strep is not a sexually transmitted disease. Most women carrying GBS will have no symptoms. Carrying GBS is not harmful to you, but it can affect your baby around the time of birth.
GBS can occasionally cause serious infection in young babies and, very rarely, during pregnancy before labour.
How Accurate Is Testing For Gbs
The CDC recommends measuring GBS with a culture test at 35-37 weeks of pregnancy. This is done by swabbing the rectum and vagina with a Q-tip, and then waiting to see if GBS grows. It takes about 48 hours to get the results back. The goal is to get the results back before labor begins .
A culture test during labor is considered the gold standard, but this method is not used in practice because it takes too long to get results back. In a recent, high-quality study, researchers did the culture test twice once at 35-36 weeks and once during labor. They compared the 35-36 week test to the gold standard.
Of pregnant people who screened negative for GBS at 35-36 weeks, 91% were still GBS-negative when the gold standard test was done during labor. The other 9% became GBS positive. These 9% were missed GBS cases, meaning that these people had GBS, but most did not receive antibiotics.
Of the pregnant people who screened positive for GBS at 35-36 weeks, 84% were still GBS positive when the gold standard test was done during labor. However, 16% of the GBS-positive people became GBS-negative by the time they went into labor. These 16% received unnecessary antibiotics .
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Are Some Newborns More Likely To Get Early Gbs Disease
The primary risk factor for early GBS infection is when the pregnant parent carries GBS. However, there are some things that increase the risk of early GBS infection:
- Giving birth for the first time
*The bolded items are the major risk factors. However, about 60% infants who develop early GBS infection have no major risk factors, except for the fact that their mothers carry GBS .
What Happens If You Have Group B Strep
If tests find group B strep, or you’ve had a baby that’s been affected by it before, you may need extra care and treatment.
You may be advised to:
- speak to your midwife about your birth plan they may recommend giving birth in hospital
- contact your midwife as soon as you go into labour or your waters break
- have antibiotics into a vein during labour this can significantly reduce the risk of your baby getting ill
- stay in hospital for at least 12 hours after giving birth so your baby can be monitored this is not always necessary
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Dealing With A Gbs Diagnosis
A Group B Strep diagnosis can feel like the end of your natural birth plan, but it doesnt have to be. Try the above home remedies to balance your vaginal flora, but remember some things are out of your control. Many healthy mamas get a Group B Strep diagnosis. Work with your healthcare provider to find a Group B Strep treatment plan that best complements your natural birth plan. Your health and that of your babys is whats most important.
Group B Strep Infection: Gbs
Group B Streptococcus also known as Group B Strep Infection is a type of bacterial infection that can be found in a pregnant womans vagina or rectum. This bacteria is normally found in the vagina and/or rectum of about 25% of all healthy, adult women. Women who test positive for GBS are said to be colonized. A mother can pass GBS to her baby during delivery.GBS affects about 1 in every 2,000 babies in the United States. Not every baby who is born to a mother who tests positive for GBS will become ill. Although GBS is rare in pregnant women, the outcome can be severe. As such, physicians include testing as a routine part of prenatal care.
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Treating A Gbs+ Pregnancy Naturally
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Toward the end of pregnancy, most women are offered the option to test for Group-Beta Streptococcus , a bacterial colonization that exists in 25-30 percent of all healthy women. Since I’ve tested positive in all four of my own pregnancies, I’ve certainly given lots of thought to how it affects my babies during childbirth.
