Group B Strep What Should I Know?

[sste]

Bummed out by a positive group b strep test yesterday.

Anyone have any experience or opinions as to what to consider in terms of birthing/birth plan. I am pretty sure I am not comfortable skipping anti-biotics - - my understanding is that the risk of infection is not particularly high to a healthy newborn but that there are a small number of such cases with devastating consequences (death, meningitis) and that antibiotics reduce, though don't eliminate this risk. DH and I are actually quite conservative with antibiotics but it seems like if there was a time to take them it may be with a brand new baby and an infection that is potentially deadly.

Anyway, my OB said they could manage IV antibiotics through my hep-lok. Or she said another option that would give us a cushion for longer laboring at home is she could give me an oral prescription for antibiotics to take when labor starts and the follow that up with a shorter/less IV dose of antibiotics.

I read a bit online about taking various food supplements too but it did not seem like there was great evidence of any one of them being particularly effective.

Any thoughts?

[swissair81]

I was GBS positive with number 2. There was no time for me to have any antibiotics. The baby was practically half out when I walked in (oh and we didn't know I was positive until after delivery). I asked my OB about it this time (I don't actually know my status yet. Hopefully, I'll find out on Monday) & was told that I could have a heplock & they would only hook me up for abx & then take it down. I don't have the laboring at home option. I live too far from the hospital & my labors go too fast.

[SnuggleBuggles]

ASk your doula and DR. if there are any options to help treat it prior to the birth. I have heard of something called hybicleanse or something like that?? Anyway, it may or may not be in your comfort zone but I think it's always nice to know options and go from there.

The main things that I would make a big point about on the birth plan are:
-limit internal exams as much as possible. You shouldn't really need any. When it's time to push you will likely know if you don't have an epidural. And if you do have one then your uterus can just do a lot of the pushing for you anyway. The internal exams just hlp move the bacteria up higher into the system.

-same thing with membrane sweeping- weigh the risks and benefits.

-keep the amniotic sac in tact. If you are above 7cm then you might be able to break it and fly through to the pushing but don't have it broken as a matter of routine earlier than that. The sac protects the baby. You want it there as much as possible.

Bummer.

Beth

[sste]

Thanks everyone.

Beth, does an internal exam include checking dilation? My doula was going to do that at home so we could better estimate when to get to the hospital.

I am seeing the doula this Saturday and will def. check with her too.

My OB does do not do any internal sweeping during delivery and wouldn't rupture/induce/etc in advance unless I absolutely demanded it. BUT, last time around my water broke in advance of labor . . . and I didn't progress with any contractions. So, I have no idea if that is a random thing or if there is a tendency for it to happen in subsequent pregnancies but I think the group b strep pumps up the timing pressure even further for that situation.

I was grilling my poor OB as to how I got this (I feel vaguely DIRTY!) and she said there is not a solid grasp on why it flourishes in certain people/pregnancies but interestingly some emerging, not yet established research suggesting that eating all or mostly organic foods of all things may be one risk factor b/c there aren't antibiotics in the foods. And of course I switched to a virtually all-organic diet in the past five months so I guess I am the poster child for this theory.

[citymama]

I had the exact same post about 3.5 months ago! I was GBS positive both times, I took the antibiotics with no apparent risks to me or the babies. I was going to be getting a hep lock anyway as a VBAC mom, and I decided that of all the things I did feel strongly about doing one way or the other, this was not one of them. If I hadn't had time for the antibiotics, that would have been fine too. In Europe, they don't give antibiotics to GBS pos moms automatically; they observe the babies for signs of infection.

[SnuggleBuggles]

I don't know about the organic connection...it's interesting but 30% of people are GBS+ and have been for quite a long time. I doubt there are that many people eating an organic diet. It comes and goes even in the same people. Some times people retest a few weeks later and test negative, I guess that's an option.

My water broke at the onset of labor with ds1 and in my later research it was one of the things that has a higher rate of happening if baby is posterior, which ds1 was. Another reason to work on optimal positioning in the later weeks.

Yes, an internal exam is the one to check dilation etc.. I would consider other ways of gauging progress like emotional and just how steady contx are. I can't remember if you read the Bradley birth book or not but if you haven't, this is a description of the emotional signposts of labor- they are handy!
http://www.angelfire.com/nb/doulaamanda/Labor.html

Your OB continues to be a major gem in my book. Why aren't more like her??

Beth

[luv2bmommy]

Wow, never heard the possible organic correlation before, but it could explain my scenario, as I consumed almost a complete organic diet with DS, and was so disappointed to come out GBS+. Also allergic to PCN, I could only get Clindamycin which was not the best for treatment. At the end, DS still ended up in the NICU with Ampicillin and Gentamycin, still unclear what kind of infection his lungs had. As in your case, my water had also broken, about 12 hours before labor, and, it being a teaching hospital, I doubt there was anybody left who did not do an internal exam on me!!! I am still eating almost all organic this time around, and am dreading the GBS test result this time. However, my OB had told me that once positive, for future pregnancies they automatically recommend abx. Am 50-50 as to what to do this time around, wanting to attempt vbac, read natural remedies for GBS as well, but as you said, the pros and cons, maybe will go for it. Last thing, both DS and I suffered one month from what looked like cdiff stools, not painful but not fun either.

[sste]

I should be clear before everyone swears off organic that my OB said research was still preliminary and even if established it would be one risk factor among several possible risk factors! And it seems like in many/most cases it more or less just happens.

But, I personally didn't have it last pregnancy and I was asking my OB if it could be anything dietary (I was thinking like yeast infections) and she said possibly the organic thing and people were currently studying that. I switched to an all-organic grocery delivery service a few months back. I imagine there must be benefits to organic too - - that was why I switched. But, I am going to be a bit peeved if five or ten years from now it turns out that organic does increase the risk!

[luv2bmommy]

I should be clear before everyone swears off organic that my OB said research was still preliminary and even if established it would be one risk factor among several possible risk factors! And it seems like in many/most cases it more or less just happens.

But, I personally didn't have it last pregnancy and I was asking my OB if it could be anything dietary (I was thinking like yeast infections) and she said possibly the organic thing and people were currently studying that. I switched to an all-organic grocery delivery service a few months back. I imagine there must be benefits to organic too - - that was why I switched. But, I am going to be a bit peeved if five or ten years from now it turns out that organic does increase the risk!

well, you know, the amount of homemade plain yogurt I made and ate with DS and still got it... and I also plan to continue with organic, and keep my fingers crossed this time around.

[swissair81]

I was negative twice & positive once, so I can't even guess what I am.