What happens if I test positive for Group B strep during pregnancy?
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A healthy baby is what every parent wants, and for a woman who gave birth in an Oregon hospital in late 2016, she appeared to get exactly that. Unfortunately, soon after birth, the infant began to show signs of respiratory distress and was transferred to the neonatal intensive care unit. Blood cultures revealed the presence of Group B Streptococcus (GBS), even though the mother had tested negative for GBS three weeks earlier. The infant was discharged home after completing an 11-day course of ampicillin. Should the mother in this case have been prescribed intravenous ampicillin during delivery, as is usually done for women who test positive for GBS at 37 weeks of gestation?
Madhur L.
A 27-year-old woman presented to the obstetrics triage area with complaints of a stabbing pain from the lower rib cage to the knees for the previous 14 hours. The patient was 29 weeks pregnant. She stated that she rested most of the day and the pain had subsided to a dull ache. She denied regular contractions or vaginal bleeding. The patient was admitted for observation with the diagnosis of threatened labor-antepartum complications. The following tests were ordered: fetal fibronectin, genital culture, urinalysis, urine culture, C. trachomatis/N. gonorrhoeae by amplified probe, genital viral culture, and M. hominis/U. urealyticum culture. The urinalysis and fetal fibronectin were performed as STAT tests. The urinalysis was normal and fetal fibronectin was negative. The obstetrics nurse noted that the baby appeared very active. The remaining test results were as follows: • Genital culture – no group B strep isolated, normal vaginal flora present • Urine culture – no growth • C. trachomatis/N. gonorrhoeae amplified probe – negative for both organisms • Viral culture – negative • M. hominis/U. urealyticum culture – positive 1. Why is the genital culture result in two parts with a specific mention of group B strep? Because group B strep 2. Why was a molecular probe done to test for GC/Chlamydia instead of a culture? Because it is easier and does not take much time to perform it. 3. What is the significance of the positive M. hominis/U. urealyticum culture for the mother? What about for the fetus?
Sri K.
Julieta's insurance won't cover the cost of a prenatal streptococcal test, and she can't afford to pay the $1,000 on her own. Plus, she googled that the chance of having a streptococcal infection was pretty low. Unfortunately, Julieta was carrying streptococcal bacteria, so when she gave birth vaginally, the bacteria was passed on to the baby. According to the lecture, what is the most likely outcome for the newborn? There will likely be virtually no effect on the baby if it is breastfed and receives mom's antibodies. The baby will be fine as long as the proper course of antibiotics is given after the birth. The baby will struggle for a while, but her immune system will likely clear the bacteria on its own. The baby will likely die within 24 hours.
Dave K.
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