It seems most hospitals offer IV antibiotic cover in labour if membranes
have ruptured for over 18hrs whether GBS or not. This is a particular
bug-bear of mine. Firstly this is often not 'offered' but women are
basically told this is what will be done. Secondly when women have had 2
doses of AB in labour the baby still has to have hourly obs for four hours,
then four hourly obs for 24hrs. By doing this we are saying that the baby
remains at risk of infection. Surely we should not be giving the AB if we
don't trust them to prevent infection.
I can't believe the amount of obs done on babies and the ridiculous reasons
they are done. Babies are woken up to have a full set of obs done for any
old excuse. So far I have never picked up a problem with a baby by doing
obs. It is usually the mother who notices something is not right. Perhaps we
should be explaining to mothers what is normal and encouraging them to let
us know about any concerns rather than upsetting their baby every x amount
of hours to put a cold stethoscope on its chest and shove a thermomether
under its armpit.
Rachel
From: "Nicole Carver" <[EMAIL PROTECTED]>
Reply-To: [email protected]
To: <[email protected]>
Subject: RE: [ozmidwifery] Strep B
Date: Sat, 5 Nov 2005 18:04:25 +1100
Where I work no-one is swabbed. If a woman is in labour for twelve hours
she
is commenced on IV antis without knowing her GBS status. There are no other
interventions, unless labour is premature, when a HVS will be taken. It's
interesting the variety of practises out there! I would prefer to swab
women
pre labour, and then we could do away with the IV antibiotics. An IV, even
one that is bunged off, is a pest to maintain in labour.
Nicole.
PS I have not seen a baby with clinical obvious Grp B strep in 5 years.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Ken WArd
Sent: Saturday, November 05, 2005 5:52 PM
To: [email protected]
Subject: RE: [ozmidwifery] Strep B
My daughter was GBS pos. Had IV antis in labour but the staff wanted her
to stay in fir observation of bub. She was basically told the baby would
die
if she took her home. I said what rubbish. The last two places I have
worked
if mum was GBS pos, had had IV antis in labour ( at least 1 dose four hours
before the birth) then apart from the odd temp check we just observed bub.
Unknown status was only worried about if the membranes ruptured 24 hours.
Then IV antis offered. Given that the swab isn't 100% accurate and mum be
negative for the swab and colonise a day later why bother scaring women?
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Robyn Dempsey
Sent: Friday, 4 November 2005 9:32 PM
To: [email protected]
Subject: [ozmidwifery] Strep B
I have had 2 cases this year where a woman chose not to have the strep
B
swabs done antenatally. For whatever reason we transferred from home to the
hospital for birthing. The staff wanted her to have antibiotics because the
step B statis was unknown. Both times the mothers refused.
Both times the hospitals then swabbed the babies, said something along
the lines of 'we have found 'something' unknown that could be strep b" they
then recommended commencing 48hours of IV antibiotics until blood cultures
can prove otherwise( that it is not Strep B).
Because of the fear involved, the mothers chose to have the IV
antibiotics for the bubs. Blood cultures came back on both babies negative
for strep B.
Scary as it is, I relate this story to my clients and let them decide
if
they want the strep B swab or not............guess what they choose??
Sad huh
Robyn Dempsey
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