Obstetric & Gynaecology Malaysia

OBSTERIC & GYNAECOLOGY IN MALAYSIA

What is group B streptococcus?

Group B streptococcus (GBS) is one of the many bacteria that live in the body. It usually does not cause serious illness, and it is not a sexually transmitted infection (STI).


Why is group B streptococcus a concern for pregnant women?

In women, GBS most often is found in the vagina and rectum. This means that GBS can pass from a pregnant woman to her fetus during labor. This is rare and happens to 1 or 2 babies out of 100 when the mother does not receive treatment with antibiotics during labor.


How can group B streptococcus affect a newborn?

Even though it is rare for a baby to get GBS, it can be very serious when it happens. Babies who get GBS may have early-onset or late-onset disease.


What is early-onset disease?

With early-onset disease, a baby typically gets sick within 12 to 48 hours after birth or up to the first 7 days.

  • inflammation of the covering of the brain or spinal cord (meningitis)
  • infection of the lungs (pneumonia)
  • infection in the blood (sepsis)

A small number of babies with early-onset disease die even with immediate treatment.


What is late-onset disease?

With late-onset disease, a baby gets sick between a week to a few months after birth. The disease is usually caused by contact with the mother after delivery if she is infected.

Late-onset disease also is serious and can cause meningitis. In newborns, the signs and symptoms of meningitis can be hard to spot. Contact your baby’s peadiatrician right away if your baby has any signs or symptoms of disease, including

  • lack of energy, irritability ,poor feeding or high fever.

Advised Vidalyn/Appleton multivitamin drops to infant. Gripe water Woodward for infant colic


Will I be tested for group B streptococcus?

Yes, pregnant women are screened for GBS as part of routine prenatal care. The test for GBS is called a culture. It is now done between 36 and 38 weeks of pregnancy. In this test, a swab is used to take a sample from the vagina and rectum.


What if the test result is positive?

If the results show that GBS is present, most women will receive antibiotics through an intravenous (IV) line once labor has started. This is done to help protect the fetus from being infected. The best time for treatment is during labor. While treatment with antibiotics during labor can help prevent early-onset GBS disease in a baby, this treatment does not prevent late-onset disease. I practiced giving IV Ceftriazone 1gm in Assunta Hospital.


Are there times when antibiotics are given without testing first?

In some cases, women are automatically given antibiotics during labor without testing for GBS. Antibiotics may be given without testing if

  • you had a previous child who had GBS disease
  • your GBS status is not known when you go into labor and you have a fever
  • your GBS status is not known and you go into labor before 37 weeks
  • your GBS status is not known and it has been 18 hours or more since your water broke
  • you are coming in for induction of labour or LSCS.