Group B Stretococcus

Question 1

Define GBS in pregnancy.

Answer 1

GBS is the most common cause of early onset (<7d) infection in neonates.

Question 2

Explain the aetiology of GBS.

Answer 2

Commensal bacterium in vagina and rectum in 25% women. Most babies in contact will not be affected. Some will be colonised, some will be seriously ill (<12h post delivery usually).

Question 3

What are the risk factors for GBS?

Answer 3

Positive Herpes Simplex Virus/lower vaginal swab/rectal swab, MSU

Previously affected baby

Preterm

PROM

Pre-term labour

Question 4

Summarise the epidemiology of GBS.

Answer 4

Most frequent cause of early onset neonatal infection, 0.5/1000 births UK.

Question 5

What are the signs of GBS?

Answer 5

Asymptomatic

Detected on MSU, HSV or LVS

Question 6

What is the management of GBS?

Answer 6

IV antibiotics in labour (benzylpenicillin OR clindamycin if allergic) if detected antenatally with MSU.

Question 7

What are the complications of GBS? What is the prognosis of GBS?

Answer 7

Neonatal septicaemia, pneumonia, meningitis, death

Treatment is 80% effective in preventing GBS within 12h postpartum (early onset). No effect on delayed infection.