You might find the RCOG , UK guidelines for the management of group b strep , of interest .I think section 9.2 covers the scenario you describe , they suggest that antibiotic use should be considered but do not recommend that it should be offered .The guidelines also discuss the risks to mother and baby of intrapartum antibiotic prophylaxis .It can be accessed in full at http://www.rcog.org.uk/guidelines.asp?PageID=106 under "Group B Streptococcal Disease ,Prevention of Early Onset Neonatal(36) - November 2003 ". Cheers, David ----- Original Message ----- From: "leanne wynne" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, October 06, 2004 10:12 AM Subject: Re: [ozmidwifery] group B strep
> Thanks Belinda and Lieve for your replies. > I will explain why I asked the question. > In Victoria the "3Centres Consensus Guidelines" recommend Penicillin 1.2g IV > then 0.6g IV 4 hourly throughout labour for those women who are GBS > positive. > Over the weekend I was caring for a teenage primip who had been GBS positive > on LVS at 38/40 gestation. She had been in early labour for 2 days before > she established at about 1pm Sunday and she was content to labour at home > for as long as possible. Later that evening she decided to stay home and > birth, which we did - beautifully!! - 3.5kg girl with perineum intact!! Her > membranes had ruptured spontaneously during transition. > However at 5 hours of age the baby gagged on some mucous, became cyanotic > and they rushed her to the local hospital. I met them in A&E and the staff > said that on arrival the baby was pink and well perfused - thank God!! They > admitted the baby to SCN for observation for 24 hours and everything was > normal. > The parents later told me of the reactions from the medical staff, both > obstetric and paediatric, when they learned that she was GBS+ but hadn't had > A/Bs in labour. I was obviously viewed as negligent or incompetent or both! > So I was just wondering what other midwives do. > Thanks, > Leanne. > > > >From: "Lieve Huybrechts" <[EMAIL PROTECTED]> > >Reply-To: [EMAIL PROTECTED] > >To: <[EMAIL PROTECTED]> > >Subject: Re: [ozmidwifery] group B strep > >Date: Tue, 5 Oct 2004 09:04:49 +0200 > > > >Hoi Leanne, > >We have a good leaflet of the Netherlands that explains very well the > >problem with GBS. Their recommandations are not to screen routinaly, but > >just in cases: > >- premature rupture of membranes > >- rupture of membranes more than 24 hours before established labor > >- several urinary tract infections during this pregnancy, caused by GBS > >- fever during labor > >- previous child that suffered from an infection with GBS at birth. > >Also in those cases AB is not routinely given, but evaluated. > >The hospitals here are not giving these info, they nearly all do routine > >controle on GBS and when positive they give AB during labor, without asking > >the parents. They just state that it would kill the baby if not. > > > > > >We handle in all pregnancys and births the same: > >- no vaginal check ups unless a real reason > >- no rupturing of the membranes > >- birth at the tempo of the mothers body > >- undisturbed contact of baby and mother during at least 1,5 h after birth > >en so > >- undisturbed start of breastfeeding > >- not cutting the cord before the pulsations stopped > >- next days observation of the baby in his mothers arms > > > >I think that is a better prevention for illness than giving Ab and than > >have > >the right to not respect the birthing process. > >We explain all this to the parents during pregnancy and they can choose > >what > >they want, but I will not administre AB at home. > > > >greetings > >Lieve > > > > > > > >----- Original Message ----- > >From: "leanne wynne" <[EMAIL PROTECTED]> > >To: <[EMAIL PROTECTED]> > >Sent: Tuesday, October 05, 2004 5:16 AM > >Subject: [ozmidwifery] group B strep > > > > > > > Hi All, > > > I am interested to hear what those midwives who attend homebirths do in > > > regard to group B strep. Do you screen for it or not? If you know a > >woman > >is > > > GBS positive do you give A/Bs to the mother during labour or just > >observe > > > the baby? > > > Thanks, > > > Leanne. > > > > > > Leanne Wynne > > > Midwife in charge of "Women's Business" > > > Mildura Aboriginal Health Service Mob 0418 371862 > > > > > > _________________________________________________________________ > > > Click here for the latest chart ringtones: > > > http://ringtones.com.au/ninemsn/control?page=/ninemsn/main.jsp > > > > > > -- > > > This mailing list is sponsored by ACE Graphics. > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > > > >-- > >This mailing list is sponsored by ACE Graphics. > >Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > Leanne Wynne > Midwife in charge of "Women's Business" > Mildura Aboriginal Health Service Mob 0418 371862. > > _________________________________________________________________ > Searching for that dream home? Try http://ninemsn.realestate.com.au for > all your property needs. > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
