Take a look at the 3 centres guidelines @
http://www.dhs.vic.gov.au/ahs/quality/effect.htm (do a google search if it's not still @ that website) The 3 centres are Melbourne's RWH, Mercy Hospital for Women, & Monash Medical Centre (the 3 tertiary centres for maternity care in Vic).
They actually recommend a CHOICE for screening of GBS:
"Prevention strategies for GBS should be included in routine antenatal care using either risk-based or bacteriological screening strategies, or both."
Risk based being monitoring for infection (Mo temp, status of membranes, Bo temp, etc)
They go on to state:
"Intrapartum antibiotics are recommended for pre-term birth <37 weeks, rupture of membranes >18 hours prior to delivery, maternal temperature=38C during labour, previous GBS colonisation, GBS bacteriuria or previous infant with GBS."
Sounds like a beautiful birth & great outcome.
Jen
leanne wynne <[EMAIL PROTECTED]> wrote:
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 arriv! al 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.
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