GBS in urine = C-section ?!? - Mothering Forums

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#1 of 10 Old 07-30-2009, 03:29 AM - Thread Starter
 
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My friend is 13 weeks along. She had a c/s with her 1st (unknown breech; she labored for half a day before they knew). With her 1st she had some sort of renal failure and had to see a specialist. She also was borderline pre-e (didn't meet all the criteria). I figure she must not have been too sick b/c she went into labor on her own; no induction.

She's PG now and has to see a specialist b/c of the kidney problems the 1st time. She had a positive urine test for GBS and they're treating her for the UTI (understandable). But he's also trying to tell her b/c she's positive for GBS now, she will be for the delivery and due to the GBS and the kidney history she'll need another c/s. And if she did go vaginally she had to stay "48 hours, down to the minute".

Does this sound reasonable? I'm thinking he's just not comfortable with VBACs and a bit of a wack job. My friend is not very aggressive and D/T insurance she can't go elsewhere, so I'm thinking she'll be bullied into this.

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#2 of 10 Old 07-30-2009, 03:56 AM
 
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GBS is transient and not an indication for c/s even if the mother is positive at the time of birth. Without knowing what her renal problems are I can't really comment on whether that is an indication but, off the top of my head, I can't think of any renal condition that would automatically require a c/s. Sounds to me like he may be looking for reasons not to VBAC as you suspected.

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#3 of 10 Old 07-30-2009, 07:22 AM
 
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That is not reasonable. According to current guidelines it is recommended she receive IV antibiotics during labor (no rectovaginal culture necessary to confirm colonization at the end of pregnancy). C/section for GBS, regardless of the route of diagnosis, is ridiculous.

Also, the GBS and the renal problems are not related.
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#4 of 10 Old 07-30-2009, 09:24 AM
 
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GBS is really not a good reason to do a C/S- probably is true that the doc is uncomfortable with VBAC - it is true that the GBS is not going to be considered gone and they are not going to re-test because colonization of the urinary tract is considered HIGHLY colonized and the strains of GBS that live in the urinary tract tend to be the invasive kind and more likely to cause an infection in a baby- do they know what the primary cause of her renal damage is? in the first pregnancy pre-existing renal damage could have thrown the baseline labs off and would have looked like PE when she didn't have PE, or it could be that she had PE that caused the renal damage-
I do have some concerns for her overall health but that does not mean we should automatically jump to doing surgery
a word of caution your friend should not be doing a Brewer diet- her kidneys are already taxed and may very well not be able to handle extra protein- on the other hand her diet should be very low in simple sugars- no kidding around
as far GBS in her urine who knows which came first the GBS infection causing the renal damage or the renal damage encouraging the GBS infection- here is a quote from an older study done in the 70's on GBS UTIs

"Of the forty-eight patients with this infection, forty-three were female. In nine patients the infection followed renal transplantation while in nine others it occurred in the presence of chronic renal failure. The rest, who included seven females who developed the infection following hysterectomies, had other clinical conditions which could have predisposed to such infections."
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#5 of 10 Old 07-30-2009, 09:36 AM
 
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I agree and think the doc is a "whack job" though I'm biased since I think that 99% are... lol

There is an article here on Mothering about GBS and the real statistics behind, good reading I suggest you do it then pass it on to your friend.

One other thing I wanted to mention is the your friend has two signs of iodine deficiency, the kidney problems and Pre-e are both indicators. I have a website I am not allowed to post but you can find all the info there, just pm if you want it.

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#6 of 10 Old 07-30-2009, 11:27 AM
 
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Originally Posted by mwherbs View Post
"Of the forty-eight patients with this infection, forty-three were female. In nine patients the infection followed renal transplantation while in nine others it occurred in the presence of chronic renal failure. The rest, who included seven females who developed the infection following hysterectomies, had other clinical conditions which could have predisposed to such infections."
I did not know this! Do they know what the correlation is?
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#7 of 10 Old 07-30-2009, 12:42 PM
 
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Originally Posted by heymama1+1 View Post
And if she did go vaginally she had to stay "48 hours, down to the minute".
Well, staying 48 hours to observe the baby is standard if you are GBS+ and get NO ABTs. (I think it was an Assoc of Family Physicians where I read that, not sure.) That was policy at my hospital as well. Although it's a bit silly since EARLY-onset GBS infection shows symptoms with 24 hours of birth like 90-some% of the time. Whereas the LATE-onset can not show signs for up to 3 weeks or so. So it's not that logical to require hospital-stay for 48 hours. But I decided just not to argue on it.

Anyway, the 48-hour hospital stay is to observe the baby. So, who gives a hoot what this OB says?! If he's willing to discharge Mama in less than 48 hours if delivery is vaginal, then it's a Q for the pediatrician how long he'll require observation for baby.
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#8 of 10 Old 07-30-2009, 01:11 PM
 
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I was GBS+ in urine w/ my second pregnancy midway through pregnancy. I had a HBAC.

Annabelle Catholic wife to Jeff '92 and mom to Makaley 19 Arden 19 Anniston 17 Taegan 14 Balen 12 Kellen 10 Ellery 8 Innish 6 Eiley 4 Finnian 3 Esca 2 our 8th uc.jpghomeschool.gifwaterbirth.jpgIHhbac.gifbftoddler.gifvbac.gifand expecting sweet pea January 2014.

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#9 of 10 Old 07-31-2009, 05:36 PM
 
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Originally Posted by MegBoz View Post
Although it's a bit silly since EARLY-onset GBS infection shows symptoms with 24 hours of birth like 90-some% of the time. Whereas the LATE-onset can not show signs for up to 3 weeks or so. So it's not that logical to require hospital-stay for 48 hours. But I decided just not to argue on it.
Are you saying since you can't get timely diagnosis and treatment all cases of GBS disease there's no point in trying to catch any? I don't understand your logic. Early onset disease is more common and more deadly, and as you pointed out usually manifests during the 48 hour observation window. I don't understand your logic.
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#10 of 10 Old 08-01-2009, 09:02 AM - Thread Starter
 
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Thanks all... I'd never heard of a c/s being required for GBS so I figured this guy was blowing smoke. Other people have had supported VBACs at this hospital so I'm thinking it's just her specialist. Eeek. Good luck to her

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