RE: [ozmidwifery] Strep B screening

Mon, 07 Nov 2005 22:04:42 -0800

Title: Message

The international guidelines (Center of Disease control, USA) say that each pregnancy is to be treated separately unless you previously had a strep B positive baby. Even then, while it is in the guidelines, it is bit of guesswork as to whether you will be positive in the present pregnancy. So, test each pregnancy and if neg, no need to have IV Ab’s. MM

 

From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Nicola Morley
Sent: Tuesday, 8 November 2005 12:17 PM
To: ozmidwifery@acegraphics.com.au
Subject: RE: [ozmidwifery] Strep B screening

 

Can I ask a personal question on this one? Last birth (January 2003, Gosford Hospital Community Midwives) I was given intravenous antibiotics automatically because I had been StrpB positive in the previous pregnancy. I wasn't retested. I am pregnant again - will I be automatically assumed to have Strep B again? will I be tested again? Is it even possible to be clear now even if I have been Strep B positive in the past or am I hoping in vain to avoid the treatment? It only bothers me because I like to spend a LOT of labour on my hands and knees and I found the drip in my hand very uncomfortable. If it is inevitable to have them again, what is the best plan of action? To stay home as long as possible? To ask for the drip in my forearm instead of the back of my hand? Any other suggestions. I will of course talk about it with the midwives when I book in next week, but just wondering in the meantime, seeing the topic has come up here!

 

Nicola Morley

Trainee Doula

 

-----Original Message-----
From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Jenny Cameron
Sent: Tuesday, November 08, 2005 12:23 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] Strep B screening

Current recommendations in Vic are to offer screening at 35-37 weeks per the CDC evidence. It does appear to be the best available evidence, far better than the risk-based approach of administering IV ABS to a select group of women considered to be 'at-risk'. Women are unlikely to change their status within a month, therefore with screening only those women who test GBS +ve will be offered IV ABs intrapartum to prevent early onset (within the first week of life) GBS pneumonia in the neonate. Also surface swabbing and collection of gastric asp on neonates is a waste of time, the baby will be sick with GBS well before the results of any swabs are available. Many years ago I saw a baby become ill & subsequently die of GBS pneumonia. The baby was term & perfectly welll at birth, within an hour of birth started having apnoeic attacks and four hours later was shocked & gravely ill. The Vic guidelines are currently under review but you can check the site below:

 

 

Jenny

Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717

 

 

----- Original Message -----

From: diane

Sent: Monday, November 07, 2005 8:17 PM

Subject: Re: [ozmidwifery] Strep B screening

 

With respect Jenny,

Im not sure that too many of the recommendations out of the good old U.S of A could be described as 'best practice'.

Here is the NSW directive, it does however, also refer to the CDC guidelines

 

 

At our unit we do not routinely swab, we take the risk factor approach,but if it appears in MSU or on a swab done for other reasons we then require our women to birth at Gosford where there are paediatricians they can transfer back after 24-48 hrs

Cheers

Di

----- Original Message -----

Sent: Sunday, November 06, 2005 4:52 PM

Subject: Re: [ozmidwifery] Strep B screening

 

Curent best practice is to offer screening for GBS at 35-37 weeks. See site below:

 

 

Jenny

Jennifer Cameron FRCNA FACM
President NT branch ACMI
PO Box 1465
Howard Springs NT 0835
08 8983 1926
0419 528 717

 

 

----- Original Message -----

From: Mary Murphy

Sent: Friday, November 04, 2005 6:47 PM

Subject: [ozmidwifery] Strep B screening

 

I have been told by a pregnant woman that she was reluctant to have a strep B test at 35-37 weeks. She was informed by a doctor in the A/N clinic of our public tertiary hospital, that if she went into labour with an “unknown status” and attended the delivery suite , her baby would have to be given IMI antibiotics until the baby’s screening swabs came back 48hrs later.  She felt that to protect the baby, she had to consent to A/N screening.  Those who recognize the description of this hospital, is that true?  Or has this lady been unintentionally misled?  Does this happen in any other hospitals?  Feel free to email me off line if you don’t want to “speak” publicly. Thanks, MM

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