For those interested GBS-Group B Streptococcus (Streptococcus agalactiae) is a 
bacterial organism that normally resides in the vagina or lower intestine of "up to 
one third of healty women".  Many people carry GBS in their bodies but do not become 
ill ( they become carriers).  

Babies born whose Mothers have this organism have a risk of infection with this 
organism -risk factors indicate/suggest Pre Labour ROM is significant, however other 
factors compound this ie vaginal examinations length of pre labour ROM.  Some suggest 
immediate IOL.

There is a considerable amount of discussion re management strategies.  The Obs at the 
Base here choose to perform HVS @ 36/40 and Women who were +ve (or evidence of +ve 
urine culture, previous history of GBS in other preganancy)  were actively managed 
with IV antibiotics  in labour and their Babies had septic screening.  A positive 
culture may show at any time in a pregnancy,  unnecessary wide spread use of 
prophylactic antibiotics is definately a worldwide problem and evidence based practice 
is essential.  In conjunction with this knowledge and the new research project to be 
overseen by the Mater Mothers Hospital in Brisbane - our policy is under review.  

The main concern in the latest research is that Women who experience Pre Labour ROM 
are at greater risk of infection as are their Newborn babies. Here may be a good time 
to just look at the quoted stats on the previous e-mail.  It is difficult to try to 
summerise so much information hence the abbrev.  a good source of information may be 
the Corchrane data base. As with everything it becomes so very difficult to give Women 
accurate research so they are able to chose what best suits their Family care, desires 
and possible outcomes of these choices.   Nobody wants to see comprimised Babies or 
Mothers but care strategies may also include options of greater risks becomming 
evident before active prophylactic management ie fever in labour, lenght of pre labour 
ROM, observing the Baby for resp dist or possible infection postnatally etc.

Heather the abbrev- Intrapartal antibiotics if less than 35 weeks labour

Caroline do the Women you care for often experience pre labour ROM or was this my 
misunderstanding?

Hope this fills some voids
cheers 
Katrina

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