GBS in pregnancy

Question 1

What is GBS in pregnancy

Answer 1

Group B strep
Gram +ve steptococus with characteristic group B lacnefield antigen - strep agalactiae
cocci in chains
most common cause of early onset infection in neonates

Aetiology -commensal in womans vagina (25%)
majority of babies dont care, but some colonised, few ill)

RF - indications for GBS prophyalxis-
intrapartum fever, confirmed chorioamnionitis
Prolonged rupture of memebrane
Pre term
previous infant with GBS
maternal GBS colonisation - not screened for (unlike HIV, HBV, syphyllis)

Question 2

Sx and ix of GBS in pregnancy

Answer 2

Sx- asymptomatic until incidental at best
Ix - often incidental
HVS, LVS, rectal swab, mSU

Question 3

Mx of GBS in pregnancy

Answer 3

aneantal discovery - no prophylaxis
Intra partum - Prophylactic Abx
1st line benzylpenicllin (vancomycin if allergy
if C section, no need

RF - see other card but intrapartum fever, confirmed chorioamnionitis, Prolonged rupture of memebrane, Pre term, previous infant with GBS, maternal GBS colonisation

Monitor neonate -
if mother >4h prophylactic abx before delivery -no monitor
If mother <4h prophylactic abx -monitor vital signs
every h for 2 h, then 2h for 12h

Question 4

Sepsis monitoring for GBS in pregnancy

Answer 4

Post partum- new borns with 1RF remain in hosp for 24h
2RF or one red flag - sespsi abx and screen
Cefotaxamine, amikacin, ampicilin

RED FLAGS-
intrapartum abx for suspected sepsis
Resp distress >4 post delivery
seizrues
Mechanical venilation
signs of shock