Group A Strep?

[Brisen]

I found out today that my GBS swab came back negative, but it was positive for group A strep. I was planning on a homebirth with midwives; they said that the recommendation when strep A is present is 24 hours of monitoring in the hospital after birth, but it was up to me if I still wanted to birth at home and not go in for the monitoring. The danger isn't really to the baby, but to the mom getting a postpartum infection. The OB they consulted said that since I'm not symptomatic now, he didn't recommend antibiotics during labour, because he was worried about thrush.

So, now that I've had some time to think about it, there are a few things I'm wondering about that I would like to find out more about before I go ask my mws about them.

I've heard about hibiclens being used for GBS; my understanding is that it is applied topically to kill the bacteria. Would this work for GAS? I'm only finding info on using it for GBS.

I'm wondering why, if antibiotics are given routinely for GBS during labour, they wouldn't give me IV antibiotics after the birth as a similar precaution? I mean, I get the worry about the overuse of antibiotics, but if it means that the 24 hours of monitoring isn't as crucial because I'm already being treated, I'm willing to risk it, personally. I was planning on consenting to the antibiotics (at home) if I were GBS positive; is there a reason why it's so different for GAS?

I guess it just seems strange to me that if they know the bacteria is in there now, and they know how to treat if I get an infection, there isn't anything they can do before I go into labour to get rid of it, if it's so dangerous that they recommend a hospital birth and want 24 hours of monitoring after the birth. My oldest was born in a hospital, and post partum was very rough -- my milk seemed to refuse to come in as long as I was still in there. So far, I've been feeling relieved that everything was going well for a homebirth, in light of the H1N1 stuff -- I thought avoiding the hospital would be a good thing.

Anyway, that's a lot of rambling to ask if anyone has had experience with this and/or any thoughts about my questions.

[thefreckledmama]

I thought strep A was the strain that caused strep throat? If that's the case don't antibiotics knock that out?

ETA: I found this link..http://www.dhpe.org/infect/strepa.html

and this one: http://en.wikipedia.org/wiki/Group_A...ccal_infection

Basically, I don't understand why you wouldn't be treated with antibiotics now, which from what I've read would eliminate the Strep A in your system.

Unlike strep B, it's not something that colonizes your body permanently, but you contract from someone else, treat, and is eliminated.

[etsdtm99]

I would be really concerned about antibiotics during labor and developing thrush too.. that would be a major major concern of mine.. it can cause serious BFing trouble.. and is a major pain to get rid of. like a PP said, i don't see why for GAS you couldn't treat now and test again? you could also try things like raw garlic .. then again, some people are carriers of strep (the strep that makes strep throat etc) could you be a carrier? in that case, antibiotics might not help?

also, do you know what they monitor for ? a fever? some other symptom? why couldn't you monitor for fever at home and head to the hospital at the first sign of fever going up?

[Brisen]

Originally Posted by thefreckledmama

I thought strep A was the strain that caused strep throat? If that's the case don't antibiotics knock that out?

Basically, I don't understand why you wouldn't be treated with antibiotics now, which from what I've read would eliminate the Strep A in your system.

Yes, they said it was the same bacteria that caused strep throat. I asked them about taking antibiotics now, and they said it wouldn't work. I'm wondering why, too.

Originally Posted by etsdtm99

I would be really concerned about antibiotics during labor and developing thrush too.. that would be a major major concern of mine.. it can cause serious BFing trouble.. and is a major pain to get rid of. like a PP said, i don't see why for GAS you couldn't treat now and test again? you could also try things like raw garlic .. then again, some people are carriers of strep (the strep that makes strep throat etc) could you be a carrier? in that case, antibiotics might not help?

also, do you know what they monitor for ? a fever? some other symptom? why couldn't you monitor for fever at home and head to the hospital at the first sign of fever going up?

Yes, that's a good point about abx and breastfeeding... I'm weighing one scenario against the other, and I've had experience with having difficulty bfing in the hospital, but I've never had thrush, so it's hard for me to judge.

They do monitor for a fever, as well as a few other symptoms, like pain. It's basically childbed fever that they're looking for; strep A is one of the bacteria that causes it. I think the rationale for doing the monitoring in the hospital is so they can start the abx right away if there is a sign of infection. It can get bad quicky.