Re: [ozmidwifery] Strep B screening

[Lisa Barrett]

Title: Message

Hi,  This is a great question.  There are choices for you here.  You could ask for a further vaginal swab for GBS to check your status at the end of your pregnancy.  And if you test positive you could decide whether or not you wanted antibiotics at all.  They can only insert an IV and administer antibiotics if you let them.   OR you could decide that you don't really want to know your status and refuse antibiotics. OR you could just take the antibiotics on your previous positive result. The main thing is you do actually have a choice in this. Your body your baby your birth. All the guidelines for antibiotics are made up from the current available evidence.  Below is taken from the Cochrane report, a review of available information.  As you can see at best it is quite ropey and even though they saw a reduction in infection there was no change in neonatal mortality. I am a British midwife and until I came here to work I didn't see anyone tested for GBS or an infected baby.(I have been a midwife since 1988) The best thing you could do is check the evidence for yourself.  Not the guidelines but the evidence that the guidelines are made up of then make a decision of how you want your labour to be. Lisa COCHRANE REPORT Five trials were included. Overall quality was poor, with potential selection bias in all the identified studies. Intrapartum antibiotic treatment reduced the rate of infant colonization (odds ratio 0.10, 95% confidence interval 0.07 to 0.14) and early onset neonatal infection with group B streptococcus (odds ratio 0.17, 95% confidence interval 0.07 to 0.39). A difference in neonatal mortality was not seen (odds ratio 0.12, 95% confidence interval 0.01 to 2.00). Authors' conclusions Intrapartum antibiotic treatment of women colonized with group B streptococcus appears to reduce neonatal infection. Effective strategies to detect maternal colonization with group B streptococcus and better data on maternal risk factors for neonatal group B streptococcus infection in different populations are required.