Group B Strep - Have You Been Tested?

Antenatal testing for HIV and other serious diseases such as Hepatitis B are routine in Ireland. Most likely you signed a consent form for a blood test to be done at your booking appointment and that was the last you heard of it. If you were positive for these diseases the hospital would notify you and discuss a plan of care for you in pregnancy and labour. These diseases can pass to your baby – however they are rare. Group B strep colonization is not a sexually transmitted disease (STD). Approximately 25% (1 in 4) of pregnant women carry group B strep bacteria in their vagina or rectum. For most women there are no symptoms of carrying group B strep bacteria. The bacteria can pass to your baby during labour. It is the most common cause of life-threatening infections (sepsis, meningitis, pneumonia) in newborn babies. 90% of early onset GBS infection is preventable by treating mum with IV antibiotics in labour – and yet most Irish women are not routinely tested and in some cases Mums are put at additional risks by routinely breaking the waters in labour without knowing Mum’s GBS status. Most Irish/UK hospitals only treat mums who have specific risk factors; however 40% of babies that develop GBS have no risk factors. • You carry Group B Strep in your body • You’ve had a previous baby infected with GBS, • Your waters have released for more than 18 hours • Your labour starts before 37 weeks • You have a temperature in labour, • Multiple pregnancy, • Your baby’s heart rate is high throughout labour [b:3qo1w43t]How Accurate is the Test?[/b:3qo1w43t] If you’ve been diagnosed with GBS in a previous pregnancy you’re 38% more likely to have it in a subsequent pregnancy. Maybe you’ve been tested and found to be negative but another big problem is the reliability of the tests for GBS. The process called ‘Direct Plating’ is the most commonly used test and involves a swab taken from high inside your vagina (HVS). However this test only detects around 50% of infections. The gold standard and more accurate test is the ‘Enriched Culture Medium’ (ECM) but not widely used. A swab is taken from low in the vagina and the rectum around 35 – 37 weeks and is predictive for about 5 weeks. There’s no way of knowing if you’re carrying GBS without a test. These tests all involve incubating the bacteria for around 48 hours to see if the GBS bacteria shows up. There is also a rapid test PCR that can be done bedside and the result is available in less than 2 hours and no lab is required – however this is expensive. Pharmaceutical companies are currently developing a GBS vaccine – Novartis recently trialed a vaccine in South Africa but it’ll be several years before these are widely available. Keep in mind that no screening test is entirely accurate. A negative swab doesn’t guarantee that you’re not a carrier and even with antibiotics in labour no treatment is guaranteed to work all the time for everyone. These days most people are trying to reduce their antibiotic use as bacteria become more resistant however according to UK figures 1 in 300 babies will develop early onset GBS without having antibiotics in labour whereas only 1 in 6000 babies will develop GBS after Mum has received antibiotics in labour. Speak to your midwife/consultant at your next appointment about testing for GBS. If testing is not available you can purchase a private test (ECM) you can do at home from sonichealthcare.ie – before purchasing the test please discuss with your caregiver your labour care plan if you are positive (in other words will the hospital accept the privately done test as evidence of being GBS positive?). Some women under the private care of a consultant do get tested however the test is processed in the hospital’s public lab so all mothers should have access to this test. [b:3qo1w43t]Signs to look out for after your baby is born.[/b:3qo1w43t] If your baby is unwell due to early onset GBS it is likely to show up in the first 12 – 24 hours. Ongoing grunting of your baby. Not feeding well Seems lethargic Irritable High or low temperature High or low heart rate If you have any worries about your baby’s wellbeing speak to a midwife on the postnatal ward. For more information visit - http://www.gbss.org.uk/ I’ll post more about late onset GBS this week.

I had a Strep B infection about 3 years ago-wasn't pregnant at the time and my god it was horrible, I didn't know what was wrong and went through 3 sets of antibiotics and had to wait for bloods/cultures to come back. I'm now 10 weeks pregnant and my hospital have said they will treat me with Iv antiobiotics while in labour just incase as I had it so badly before. Hopefully that will cover me and the baby. I'd really recommend ladies get tested for it, I don't know why all hospitals don't routinely test for it anyway.

Thanks for that post- very informative. I'm actually being tested this week for GBS but only because I told the consultant that I had tested positive for it during a previous smear - I was never asked!! It seems crazy that they don't even ask if you've ever tested positive for it, let alone routinely test for it.

Posted above before seeing your thread on this. Something I'm considering so interested in everyone elses responses.

I think it's so backward that we don't test for this in Ireland routinely. It can be a serious thing.

It seems that some hospitals do a urine test in pregnancy but we don't know if they are using the gold standard test or the test that only picks up 50% of carriers.... This is definitely a case of what you don't know can hurt you. Tracy

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I have this, told after a smear a few years ago, forgot about it until I saw this post

I have this . I was tested automatically for it in Limerick its just a general part of their admin procedure as i had never even heard of it until was told I have it and i wouldn't have any of the higher risk factors or anything. Guess everywhere is different>>??

I requested a strep b test in my hospital on my last pregnancy and was told no they wouldnt do it because I wasn't in the risk category!