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On the Road to Delivery…GBS

While the title may have you doing a double take (and maybe even looking for some directions on how to decode GBS), rest assured, you are not lost out there on the road. You are in your home, your apartment, your office, or maybe even in the car (although hopefully not driving and reading!) hanging with your girlfriends at Truly, MD. But if you are nearing the end of pregnancy, you are probably getting pretty good at navigating the streets between home base and the hospital. And although we may not know the quickest way to get you to the labor floor, we definitely know how to get you up to speed on all things third trimester. First stop: Group Beta Streptococcus (a.k.a. GBS).

GBS is a type of bacteria. And although it may not be on your daily bacteria radar (think strep throat or staph skin infection), it is pretty important to us OBs. GBS took center stage in the OB world of the 1970s when it was identified as a culprit in the land of perinatal morbidity and mortality—that is, newborn illness and death. The newborns of pregnant women with GBS in their vaginal canal who were not given antibiotics during labor were at risk for some pretty heavy hitters. Think sepsis, meningitis, and death. Pregnant women were not immune to the negative effects of GBS. They, too, were at risk for things like UTIs and uterine infections.

Despite its bad-guy tendencies during pregnancy, GBS lives fairly peacefully within the vaginas and the rectums of non-pregnant women. Don’t bother me, and I won’t bother you. Given its Jekyll and Hyde persona, we only start to look for the presence of GBS in a woman during the latter half of pregnancy, when it can really turn into Hyde. To uncover whose vagina/rectum is “covered” in GBS and whose is not, your OB will perform a screening test on you between 35 and 37 weeks. And although it may sound scary, it’s no more than a cotton swab test of the vagina and the rectum. Those that test positive are given antibiotics during labor. Those that test negative are not. Pretty simple.

The ACOG has made it their business to get in the business of all pregnant women when it comes to GBS because, like the old adage says, when GBS is bad, it is very, very bad. Anything that can be done to decrease the bad is a major bonus…cue screening for GBS. The universal screening of all pregnant women has done a very, very good job at stopping most widespread GBS infections in newborns, particularly in the first six days of a baby’s life. In fact, since national guidelines for screening and treating pregnant women who test GBS positive were implemented, there has been nearly an 80% reduction in early onset (the first six days of life) neonatal sepsis due to GBS. Pretty impressive stuff.

Women who go into labor before their GBS test was performed (a.k.a. preterm labor), women who have previously given birth to a GBS-infected newborn, or women who test positive for a GBS UTI during pregnancy are automatically treated with antibiotics for GBS during labor. Basically, in these cases where the risks are high, it’s better to be extra safe and add an extra layer of protection. It’s sort of like extra insurance for a driver with lots of points on his license. While he may never speed or get ticketed again, given that his chances are higher, you want extra protection—we’re not saying we know anyone like this!

For most women, the GBS test comes and goes without a bump in the road. It’s sort of like passing a yield sign on the road. You know it’s there. You slow down somewhat, but you don’t really pay it much mind (we didn’t say that we offered good advice on driving!). Don’t fear the results. Positive or negative, we are pretty good at directing you to the right path. No one gets lost out here on this road; think of us as your GPS for your GBS!