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Can I
ask a personal question on this one? Last birth (January 2003, Gosford Hospital
Community Midwives) I was given intravenous antibiotics automatically
because I had been StrpB positive in the previous pregnancy. I wasn't retested.
I am pregnant again - will I be automatically assumed to have Strep B again?
will I be tested again? Is it even possible to be clear now even if I have been
Strep B positive in the past or am I hoping in vain to avoid the treatment? It
only bothers me because I like to spend a LOT of labour on my hands and knees
and I found the drip in my hand very uncomfortable. If it is inevitable to have
them again, what is the best plan of action? To stay home as long as possible?
To ask for the drip in my forearm instead of the back of my hand? Any other
suggestions. I will of course talk about it with the midwives when I book in
next week, but just wondering in the meantime, seeing the topic has come up
here!
Nicola
Morley
Trainee Doula
Current recommendations in Vic are to offer
screening at 35-37 weeks per the CDC evidence. It does appear to be the best
available evidence, far better than the risk-based approach of administering
IV ABS to a select group of women considered to be 'at-risk'. Women
are unlikely to change their status within a month, therefore with screening
only those women who test GBS +ve will be offered IV ABs intrapartum to
prevent early onset (within the first week of life) GBS pneumonia in the
neonate. Also surface swabbing and collection of gastric asp on neonates is a
waste of time, the baby will be sick with GBS well before the results of any
swabs are available. Many years ago I saw a baby become ill & subsequently
die of GBS pneumonia. The baby was term & perfectly welll at birth, within
an hour of birth started having apnoeic attacks and four hours later was
shocked & gravely ill. The Vic guidelines are currently under review but
you can check the site below:
Jenny
Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box
1465
Howard Springs NT 0835
08 8983 1926
0419 528 717
----- Original Message -----
Sent: Monday, November 07, 2005 8:17
PM
Subject: Re: [ozmidwifery] Strep B
screening
With respect Jenny,
Im not sure that too many of the
recommendations out of the good old U.S of A could be described as 'best
practice'.
Here is the NSW directive, it does however,
also refer to the CDC guidelines
At our unit we do not routinely swab, we take
the risk factor approach,but if it appears in MSU or on a swab done for
other reasons we then require our women to birth at Gosford where there are
paediatricians they can transfer back after 24-48 hrs
Cheers
Di
----- Original Message -----
Sent: Sunday, November 06, 2005 4:52
PM
Subject: Re: [ozmidwifery] Strep B
screening
Curent best practice is to offer screening
for GBS at 35-37 weeks. See site below:
Jenny
Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box
1465
Howard Springs NT 0835
08 8983 1926
0419 528 717
----- Original Message -----
Sent: Friday, November 04, 2005
6:47 PM
Subject: [ozmidwifery] Strep B
screening
I have been told by a
pregnant woman that she was reluctant to have a strep B test at 35-37
weeks. She was informed by a doctor in the A/N clinic of our public
tertiary hospital, that if she went into labour with an “unknown status”
and attended the delivery suite , her baby would have to be given IMI
antibiotics until the baby’s screening swabs came back 48hrs
later. She felt that to protect the baby, she had to consent to
A/N screening. Those who recognize the description of this
hospital, is that true? Or has this lady been unintentionally
misled? Does this happen in any other hospitals? Feel free
to email me off line if you don’t want to “speak” publicly. Thanks, MM
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Checked by AVG
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