GBS and Pregnancy Don’t Mix – Get Tested!

18 07 2011

Pregnant? Do not fail to be tested and TREATED for group B strep infection

The first story I read was heartbreaking. A mother-to-be at 38 weeks, in for a routine prenatal appointment. The heartbeat check turns up nothing. The baby has died, and she must undergo induction for a stillbirth. Weeks later, she learns that her baby tested positive for a Group B Streptococcus (group B strep or GBS) infection of the blood and lungs. The mother had tested positive for GBS in a previous visit, but because her membranes were intact, no one was concerned.

GBS is present in about 25% of pregnant women. According to the Centers for Disease Control and Prevention (CDC), this bacteria is the most common cause of life-threatening infection in newborns. Many women undergoing standard prenatal care also undergo testing for GBS. They can carry the bacteria in the vagina or rectum without having any symptoms, but if the bacteria pass to the womb, the outcome can be devastating.

The disease in infants can be early-onset or late. Early-onset disease afflicts newborns in the first week, most commonly causing a blood infection (sepsis) or lung infection (pneumonia), although meningitis (inflammation of the brain membranes) can also happen. Late-onset disease, in which meningitis is more common, occurs from the second week through the first three months of life. Early-onset GBS infection afflicts about 1200 babies each year in the United States, with outcomes that can vary from permanent deficits such as deafness and developmental disabilities to death. In many cases, detection and treatment can prevent transmission from mother to child.

July is GBS Awareness Month. Pregnant women, parents of newborns, and healthcare providers should be aware of the following to help prevent the possible devastating outcomes of infant GBS infection:

  • The CDC recommends that all pregnant women be screened for GBS in weeks 35 to 37.
  • The standard test is a painless vaginal and rectal swab test.
  • A rapid DNA test is also available in some places.
  • A woman should be tested in each pregnancy.
  • A positive test requires follow-up, awareness, and treatment.
  • Treatment consists of antibiotic administration, often during labor.
  • Transmission usually occurs during passage through the birth canal but can occur before birth.
  • Risk factors for early-onset GBS (during the first newborn week) include early delivery, urine positive for GBS during pregnancy, fever during labor, and a long period between water breaking and delivery.
  • GBS infection in infants occurs at higher rates among African-Americans than other ethnic groups.
  • If an infant has fever, difficulty feeding, irritability or lethargy, difficulty breathing, or a bluish color to the skin, contact a healthcare provider immediately or go to an emergency room.

It’s important to note that GBS is not a sexually transmitted disease. These bacteria are simply often present in the digestive tract or the vagina or rectum of about 25% of women. A healthy adult carrier would likely never even notice their presence. That’s one reason the CDC shifted its guidelines from testing only pregnant women who had risk factors to testing all pregnant women. It’s another quick and straightforward way to prevent infection and death in infants.

For more information about GBS testing or to learn more about promoting July as GBS Awareness Month, visit Group B Strep International, an organization founded by parents of children who were born stillborn, full term, because of GBS infection. And remember…getting tested isn’t the only step in preventing GBS transmission from mother to child.

By Emily Willingham 

Image courtesy of tostadophoto.com





Preventing Baby Strep

10 02 2011

Group B strep (GBS aka Baby Strep)  is the main cause of meningitis and sepsis in newborns.  If left untreated, this bacterial infection can cause serious harm, but with the proper course of treatment, only five percent of newborns exposed to the bacteria will develop GBS disease.

One out of four pregnant women carries GBS bacteria in their vagina or rectum, although some pregnant women remain free of symptoms (vaginal burning or irritation, unusual vaginal discharge, or bladder infections), making infection a silent risk for newborns.

Symptoms of a baby infected with GBS include red or tender skin, discolored skin due to lack of oxygen, and difficulty breathing. Group B strep in babies can cause sepsis, pneumonia, meningitis and other serious illnesses.

Coupled with the potential impacts of GBS infection on pregnant women (preterm labor and early onset of water breaking), the lack of symptoms led to the U.S. and Canada specifying screening for GBS as the proper standard of care for women who are 35 to 37 weeks pregnant.

The CDC suggests the following for the prevention of GBS:

  • Testing of all preterm deliveries
  • Closer monitoring and treatment for pregnant women who are allergic to penicillin
  • Following the recommended testing guidelines at 35 to 37 weeks pregnant
  • Testing of pregnant patients who report bladder infections, unusual vaginal discharge, or vaginal irritation and burning.

Pregnant patients and their families should be aware of these recommendations and check with their doctor to ensure compliance.





The Girls and Women of Haiti

10 05 2010

The girls and women of Haiti are in trouble.

They have little protection. Some lost their husbands or loved ones (their protectors) in the earthquake, and some never had protection. Whatever the case, if they’re living in tents, there’s nothing to save them from the rape gangs. Fear keeps them from sleep.

They cannot escape disease. Rape, assault, and lack of decent medical care or basic nutrition put them at increased odds of getting infections. Add to that the cyclical challenge of mosquitos carrying malaria and their burden becomes overwhelming.

Pregnancy and childbirth, always difficult in this poor country, are made more so by the rough living conditions. Babies are being delivered in tents or on the street. If there are any complications, the outlook for a safe birth is grim.

Thieves roam the streets. A female with a bag of rice in her arms is no match for a group of hungry men. Caring for a family is at times a life-threatening chore for the girls and women of Haiti.

We sit in our office chairs, writing this as part of our Haiti Habit series of postings. They’re not just postings, though. They’re people in pain.

We can’t all fly to Haiti and lend a hand, but we can pick up the phone or go online and give a few bucks. A little bit from each of us makes for a pile of cash, and boy do they need it.

If you already support a charity working in Haiti, contact them for more information and donation opportunities. If not, here’s a list of charities to consider.

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TB Today

22 03 2010

For many of us, the words “TB” and “tuberculosis” conjure up black-and-white images of sanatoriums and large, antiquated medical equipment. Or maybe we hear those words and think, “That can’t happen to us.”

But it does. One of our staff members recently caught up with an old friend of hers, a 30-something woman living in the U.S., and discovered she’d undergone treatment for latent TB. Being who we are, we couldn’t resist the opportunity for an interview!

Abandoned sanatorium for tuberculosis

Abandoned sanatorium for tuberculosis

When/how did you find out you had latent TB?

Two and a half years ago, I was registering to be an on-call chaplain. For that type of position, you have to have a yearly TB skin test, and mine came up positive. The test is a skin prick—if you’re positive, it reacts. I immediately felt something, and the pricked area swelled up like a bad spider bite.

What were the first thoughts you had?

I was freaking out a little, because TB has such a stigma attached to it. There’s a place in Seattle that is on the site of a former tuberculosis sanatorium—a friend of mine remembers standing outside, waving to her father in the window.

I think I might have contracted TB in the mission field. It’s fairly common for mission workers or hospital workers to have it. My sister has latent TB also, possibly from working in the inner cities.

What did you do first?

You’re required to report to your local health department if you have a positive skin test, so I did. They scheduled me for treatments.

What was the treatment process like?

I had to go to the health department twice a week to take 3 pills—they watch you take them. I only missed one treatment. It was a day that I had the stomach flu and a funeral, and the health department was calling me. They were very on top of things!

It was a 9-month course of treatment. The drugs make you feel lethargic, and they upset my stomach and gave me heartburn-like symptoms. I chose the twice weekly treatment because it was less inconvenient, and also, by the third day, I’d feel better, which was better than feeling bad every day for 9 months.

I could taste the pills for months afterward every time I drove by the health department. Pregnancy is a lot easier!

Were your friends or family concerned they might be infected?

My husband was concerned at first! Also, a relative of a friend with a son who has medical issues was very concerned about my husband being around her son, even though I’m not even symptomatic.

Another acquaintance of mine who also had latent TB began to have health problems and was concerned that my TB had activated hers, but it turned out she had other medical issues that were unrelated.

It was odd, people not understanding that people with latent TB are not contagious.

Did you have any specific concerns about TB and pregnancy?

You’re not supposed to get pregnant while on the drugs. But other than that, it hasn’t been a concern for me.

Do you ever worry you’ll develop active TB?

Taking the drugs made it less likely that I’ll get it. Night sweats, coughing—they tell you to watch out for those symptoms. I’m glad I did the treatment now, when I’m more physically capable, instead of having it be an issue at some later time when I’m not as healthy. But I don’t worry about it.

Is your life today affected by having latent TB?

No. I just keep my letter on hand stating that I’ve done the treatment so I can provide it when a convalescent center or someplace requires routine testing. I’m surprised at how TB is much more common than we think it is!

When a person has latent TB, it means that the body’s immune defenses hold the TB bacilli, preventing them from multiplying. However, any number of factors – age, cancer, steroids, to name a few – can suppress the immune system, allowing the bacilli to multiply, causing active TB disease. Treating latent TB reduces the chances of this happening by over 90%.

If you or anyone you know has been exposed to active TB disease (not latent TB), you should get tested for TB. To learn more and to help prevent the spread of TB, visit the World TB Day website.

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