Group B streptococcal infection in pregnancy

This guideline doesn’t really change our practice and a lot of it is aimed at Obs and Gynae. As a reminder:

Screening. Do not screen for Group B Strep (GBS). It is very common (21% of women).

  • Incidental Finding. If it is found incidentally, the woman will need antibiotics during labour, but not before. She can be reassured that risk to the baby is very low (2.3 in 1000 babies). Ensure this is flagged prominently in the notes.
  • Previous pregnancy with GBS. If she was found to have Group B Strep in a previous pregnancy, she does not need screening, nor antibiotics. Risk to the baby is very low (less than 1 in 1000).
  • GBS Bacteruria – if the woman has symptoms or levels are over 105, then treat the bacteruria. She will also need antibiotics in labour.
  • Women with a previous baby affected by GBS – risk to this baby is higher and the baby will need observation for at least 24 hrs after delivery. I guess we just need to be aware of this when doing neonatal checks, though hopefully they will be kept in hospital for longer.

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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