What is Group B Streptococcus?
Group B Streptococcus (GBS) is a common bacterium carried by 30 per cent of adults in their intestines, and 25 per cent of women vaginally. Most people are unaware that they carry it because it causes no symptoms and can be difficult to detect. Carrying GBS is perfectly normal. No antibiotics tested so far can reliably eradicate GBS.
When does GBS infection occur?
Babies are usually exposed to GBS shortly before, during or after birth. This happens to thousands of babies without causing them any harm. Why some babies develop an infection as a result of exposure is not yet clear.
When are babies most at risk?
Your baby is most at risk if your labour is premature, if pre-term rupture of the membranes occurs, if the waters have broken more than 18-24 hours before the baby is delivered, or if you have a temperature of 37.8 ºC or higher during labour. Babies are at greater risk of developing GBS infection if you have had GBS diagnosed during pregnancy, or if you have previously had a baby infected with GBS. Full term babies born where no ‘risk factors’ are present can and do still develop GBS infection.
Can I find out if I carry GBS?
The GBS ECM test is available privately (very few NHS trusts offer it), and is considered the ‘gold standard’ method for detecting group B Strep carriage. Swab samples are taken from the lower vagina and just inside the rectum, which are then cultured using enriched media that encourages the growth of GBS. The test is usually done around 35-37 weeks of pregnancy. The cost of the test pack, processing the swabs and sending you the results is approximately £35. You can obtain your ECM GBS test pack by contacting the following:
- The Doctor’s Laboratory*
020 7307 7373 www.tdlpathology.com/gbs
- Blue Horizon Medicals
0800 098 8751 www.bluehorizonmedicals.co.uk
0871 288 4380 www.medisave.co.uk
What does the GBS ECM test involve?
The pregnant woman orders a GBS Screening Pack by phone, fax or e-mail. This is usually sent out the same day by first-class post. Once the test pack is received, then the swabs can be taken either by the pregnant woman herself, or by her health professional*.Either way, the pregnant woman’s health professional should authorise the test and it is important to ensure that the health professional is also sent a copy of the results – the form allows space for this information to be given.
The vaginal and rectal swabs should ideally be taken at 35-37 weeks of pregnancy – they can be done earlier but then they may not be as reliable in predicting GBS carriage at delivery. They may be done later, but then there’s an increasing chance that the baby will be born before the test result is available. The swabs are then sent direct to the laboratory (with payment) in the envelope provided as part of the GBS Screening Pack.
Each laboratory undertakes to have the results available within three working days of receipt of the swabs and to post out the results on that day to the health professional, with if requested a copy to the pregnant woman. Because the swabs and the results are sent through the post, the test can be done anywhere in the country.
What about treatment?
Antibiotics given intravenously when labour begins prevents the majority of cases. Pressure groups are pressing for GBS screening in pregnancy and more information to be given at routine appointments.
Signs of GBS infection in newborns
GBS is usually present as blood poisoning, pneumonia and meningitis, each of which can be devastating to a newborn. Signs of GBS infection usually become apparent within the first two days of life, and after three months are very rare indeed. Signs in a newborn baby include:
- poor feeding
- low blood pressure
- high/low temperature
- high/low heart rate
- high/low breathing rate
“I was a Group B Streptococcus carrier”
“My daughter, Isla, was born by emergency Caesarean section 8 days past my due date. She was taken immediately to Special Care Baby Unit (SCBU). She was kept in SCBU for 3 days then discharged on day 5. All I was told was that she had an infection and was being treated with antibiotics. There were no long-term effects of this infection but we were not told to expect any. Nobody said the fact my membranes had been ruptured for 41 hours or that I had shown signs of Group B Streptoccus infection during labour.”
“Four years later I was pregnant again and met my consultant at my 12-week scan. He told me I was a GBS carrier and would require antibiotics in labour to help prevent infection in the baby. It wasn’t until I told the midwife what the consultant had said and she supplied me with information that I began to realise that this was something serious.”
“By the time I met the consultant at 36 weeks I was armed with a page of questions regarding my care, which he answered fully. At no time was I made to feel I was making a big deal about nothing. It was agreed that as soon as I had signs that something was happening I would get in touch with the hospital.”
“When my contractions started I phoned the hospital and explained I was a GBS carrier and that my daughter had suffered fetal distress. I was advised to pop up and be checked out. I ended up staying at the hospital being monitored and, once labour really got going, they started the antibiotics. I told everyone I met that I was a GBS carrier, they were probably sick hearing about it. “
“Nearly 11 hours after they ruptured my membranes, I gave birth to a healthy baby boy, Rory. He was swabbed straight away and was absolutely fine. At one point during the day, they were a bit concerned about his temperature but this sorted itself out. We came home the day after he was born.”
“I can only thank Group B Strep Support (GBSS) for all the easy to read information they have available as it meant I could discuss my care with the health professionals and ensure they had the most up to date information on my treatment. My advice to other women would be tell all the midwives and doctors that you meet and arm yourself with as much information as possible.”
“I was lucky because second time round all my questions were answered fully and I felt as though I was involved in any decision-making. I am still angry that no information was supplied when my daughter was born but the work of the GBSS can only change things for the better.”
- For further information, contact Group B Strep Support