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Discussion Starter · #1 ·
I thought I'd start a new thread where we can discuss this, as it's likely on a lot of our minds right now...

Personally, I'm not testing for it. I feel that the use of prophylactic antibiotics would cause more trouble than it's worth for the VERY unlikley case that the baby would contract GBS if I did have it. I also react strangely and strongly to antibiotics and other medications, so I don't want to chance an allergic reaction in either the baby or I by something that isn't for sure. I will be watching baby closely after birth, and if there is any sign of infection we will head to the hospital for IV antibiotics.

Also, in Europe they don't test and/or they don't give antibiotics for it and their infant mortality rates are better than the US's.

I am also fairly confident that I do not have it, as I don't get internal exams and there is a theory out there that they're more often than not spread by exams.

Sooo, there are my thoughts on it... feel totally free to disagree with me
Thought it would be a good discussion anyway


Cara
 

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I goofed & tried to post a thread about this today, but it ended up mixed in the check ups thread


Please tell me more about GBS. What exactly is it? What does/can it do to baby? What alternative treatments are there? Are there any symptoms I may have that would help me know if I have it w/o testing?

I don't like the idea of antibiotics either, but I don't know enough about the disease to completely ignore it either.
 

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Discussion Starter · #3 ·
Group B Streptococcus is a part of the normal flora (normal bacteria) found in the gastrointestinal tract of about 40 percent of women. Here's something I copied off the net

Quote:
What kinds of illnesses does group B strep cause?

In newborns, group B strep is the most common cause of sepsis (infection of the bloodstream) and meningitis (infection of the lining and fluid surrounding the brain) and a common cause of pneumonia. Group B strep disease in newborns usually occurs in the first week of life ("early- onset"). Babies can also get a slightly less serious "late-onset" form of group B strep disease that develops a week to a few months after birth.

In adults, group B strep usually causes no symptoms. However, in rare cases, it can lead to serious bloodstream infections, urinary tract infections, skin infections, and pneumonia, especially in people with weakened immune systems and other health problems, such as diabetes.

What complications can result from group B strep infection?

Group B strep infection is fatal in about 20% of infected men and non-pregnant women and about 5% to 15% of infected newborns. Babies who survive can be left with speech, hearing, and vision problems as well as mental retardation.
It should also be noted that a newborn can get GBS from other people besides the mother! Although the mother would be the most common way for baby to get it, if father or grandmother or whoever have it, as about 40% of people do, it *could* be passed on from them also.

Another site with some more stats:

Quote:
15-40% of pregnant women test positive for GBS. Transmission from mother to baby occurs in 40-73% of culture positive women. Only 1-2% of the infants to whom the GBS is transmitted develop complications as a result. Factors that can increase the risk of GBS complications are: maternal age <20 yrs, heavy colonization, premature rupture of membranes, prolonged rupture of membranes, fever during labor, preterm labor, or a sibling who had GBS. Although only about 3 in 1,000 babies develop GBS complications, the consequences can include pneumonia, meningitis, brain or lung damage, loss of sight or hearing, or death.
Then this, about 1/2 way down, goes into a lot of GBS stuff with different midwife opinions on it as well as natural treatments.

http://midwiferytoday.com/enews/enews0128.asp

Okay, I've GOTTA go bag the trash. I wanted to get you some information from the UK, but I've gotta go so it's ready when DH comes home and before the dump closes
I'll try and find some more later...

Cara
 

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Discussion Starter · #4 ·
Okay, trash is done


Here's a UK midwife little talkie thing about it

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Like most UK independent midwives, we work without set protocols. Each woman's care is tailored to her individual circumstances, and also to her own wishes regarding care. We give her the information, she makes the decisions, we then give appropriate support.

In a case like strep B, so much depends on when the woman books in pregnancy, whether or not she is symptomatic for strep B, how she is choosing to treat the condition, and so on. One woman we looked after, who had a vaginal colonisation of strep B, but who was asymptomatic, chose not to use antibiotics, but went the homeopathic route. When she gave birth, the baby was born wrapped in the membranes, which I had to puncture when the head was delivering. The baby was fine, and the mother remained asymptomatic. The baby took care of the problem herself!

You'll have gathered that we manage conservatively, and largely follow the 'wait and see' principle. Of course we were monitoring both mother and baby carefully for any symptoms, and if either had become sick would have suggested antibiotic treatment (which the woman would probably have accepted). In the event, it wasn't needed.

Comments from consultant bacteriologist

The consultant bacteriologist I consulted during the pregnancy about the woman's situation made the following general comments, which I reproduce here as they may prove useful:

1. The fact that a high vaginal swab sample may test positive for strep B does not necessarily reflect vaginal infection, but is more likely to be relatively benign colonisation. This should be assumed unless there is positive evidence of disease, such as cellulitis, vulval inflammation, or Bartolin's abcess.

2. It is unlikely that a woman with a vaginal colonisation of strep B, even if levels are raised, would carry a blood-borne infection of the same organism.

3. This being the case, it is most unlikely that such a woman's baby would be born with congenital strep B infection.

4. There is no conclusive evidence to suggest one approach more beneficial than another in treating women and babies at higher risk of strep B infection at or after birth. There is not enough evidence to support giving I/V antibiotics to the woman during labour and the baby post-delivery. Oral amoxycillin given to the woman in labour, and one dose of oral (or I/M) antibiotic given to the baby post-delivery is probably as effective.

5. Most infection of mother and baby in the early postnatal period with strep B is relatively benign, and may be adequately treated with oral antibiotics when symptoms appear. The most reasonable approach is to manage these babies expectantly - waiting to see whether or not symptoms appear.

6. In the case of pre-labour rupture of membranes, there will be an increased risk of amnionitis and intra-uterine infection, increasing with the length of time between PROM and delivery. Although this situation also may be managed expectantly, and no one strategy has been shown to be superior to any other, it could be argued that it is advisable for the woman to be admitted to hospital in this case.
From http://www.radmid.demon.co.uk/strep.htm

I think I'm done now...
 

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You are right that no-one here is tested routinely for GBS. Here's alink from NHS Direct a website and phone service set up by the government to answer FAQ about health and try to keep people from attending the ER or their GP with trivial problems.

http://www.nhsdirect.nhs.uk/articles...ArticleId=1667

This site http://www.gbss.org.uk/ has interesting info on prevention but does not recommend screening for the whole pregnant population as far as I can see.

The numbers here in the UK seem small relative to the numbers of babies born. Why should it be so different in the US?

I am shocked by the enforcement of the 1 and 3 hour GTT, GBS testing and the use of eye drops at birth for normal pregnancies in the US. IS this to do with the fact that you pay for your care directly so the more things they do the more you pay?

PS I love Radmid
check out the UK Midwifery Yahoo group too.
 

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Discussion Starter · #7 ·
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I am shocked by the enforcement of the 1 and 3 hour GTT, GBS testing and the use of eye drops at birth for normal pregnancies in the US. IS this to do with the fact that you pay for your care directly so the more things they do the more you pay?
In the US we seem to have the idea that 'more is better' and 'if it can be done, it WILL be done!' to make doctors feel important because they are 'preventing' all these things that 'could' happen. They'd like you to believe that without them your body would cease to function after a few months. I haven't seen a doctor in 3 years and am doin just fine, much to their chagrin! LOL

I am a tad biased when it comes to the US medical community, if ya can't tell, and yeah, money likely has something to do with it. Medical stuff pays well, I know, I work for the industry


Cara
 

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So okay...am I missing something here? Is this the same thing as the antibiotic eye drops in case the mother has ghonneria (sp?) or clamydia (sp?).

If not, how does a person become infected with this Strep B thing?
 

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I'm under the care of an OB so yes, it will be done, around 36-37weeks I believe?

I really don't want it done though, can i NOT consent to having it done? Anyone know?

If I do have it done how can I ensure I remain negative? Will a healthy diet help? No acidic foods and probiotics? I never tested with my first dd because I had her via c/s right at 36 weeks before I was able to be tested and with my second it was negative anyway. It's actually giving me grief because I don't want to do it but I don't want to turn off my OB either. I searched long and hard to find a supportive Dr. open to allowing a VBA2C - midwives in this area won't touch me. I don't want to be too difficult of a patient for her becasue so far she has been very supportive in allowing me to attempt a VBAC.
 

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Discussion Starter · #10 ·
Quote:

Originally Posted by mum2be
So okay...am I missing something here? Is this the same thing as the antibiotic eye drops in case the mother has ghonneria (sp?) or clamydia (sp?).

If not, how does a person become infected with this Strep B thing?
Mum2be, you haven't had your full prenatal scare! LOL! GBS is something that the baby gets from your body, potentially. The antibiotics, if you are found to culture posative (with a swab of the vaginal area) and choose to get them, are IV antibiotics during labor. Some people think that mother gets colonized with Strep B by having internal exams or being in the hospital, or else it's just a normal gut bacteria, like e. coli is a normal gut bacteria. Baby would get infected if it ingested some of it, or enough to make it sick, when passing through mom, or from anyone else who had GBS and didn't wash their hands well or something. But 'they' don't seem to worry about other people, just the mom...

Quote:
I'm under the care of an OB so yes, it will be done, around 36-37weeks I believe?

I really don't want it done though, can i NOT consent to having it done? Anyone know?

If I do have it done how can I ensure I remain negative?
I don't know when they routinely test for GBS. Of course you can NOT consent to having it done, but the doctor can also refuse to provide care for you, so it would be up to you and your doctor, I guess. Unless you want to UC


Some people think that inserting a peirced clove of garlic vaginally will prevent and/or get rid of GBS, or at least cause a person to test negative, but I've not had any experience with that.

Cara
 

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For some reason although my midwives are laid back about just about everything, they keep trying to freak me out about the GBS test. I know I *can* refuse it but they get all squirelly when I bring it up. Although I've tested neg twice in the past, I'm thinking I'll try homeopathic/herbal rememdies for GBS colonization BEFORE taking the test. (And you can take the test yourself, it's just a swab.) If I end up positive anyway, I want to insist on a re-test after another course of those same remedies. The test is absurd anyway, you could show positive one day and not the next, be negative on the day of the test and be colonized by the time of labor ...

I also have strong thougts (negative) about prophilactic (sp) antibiotic use, and also get yeast infections *every* time I take antibiotics. (Why I haven't taken them in several years.) The thought of coming out of labor with a vag yeast infection and thrush is not attractive.
 

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Discussion Starter · #12 ·
Quote:

Originally Posted by mojumi
The thought of coming out of labor with a vag yeast infection and thrush is not attractive.
My thoughts exactly! I don't know why some people get so hung up on GBS. When I told my SIL that we were having a homebirth she totally freaked out about GBS of all things. Now I just tell her that the risks of not needed antibiotics, for me and m,y baby, outweigh the benefits so we're not doing them.
 

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Quote:

Originally Posted by mojumi
The test is absurd anyway, you could show positive one day and not the next, be negative on the day of the test and be colonized by the time of labor ...
That is what I was thinking. If I am tested at my next appt I will be 35w4d, but I may not have the baby for another 2-6 weeks. Alot can happen in that kind of time frame. I am really confused on this one & can't figure what to do.

Last night I read through the info my midwife gave me & she says in 12 yrs about 6-10 babies she delivered have been treated for possible infection after showing signs of infection. None had serious side effects to the antibiotics (although thrush isn't serious it is not fun & I don't want it!!) Only 1 baby died but they are not sure exactly why, they listed "presumed sepsis" as his cause of death & the most confusing part is that baby's mom tested neg for GBS.

Non of this info from her helps me decide. I still have to read through all the info & websites listed by Cara. Thank you Cara, BTW!!!
 
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