PPRom and GBS Flashcards
Which antibiotics for pprom?
Erythromycin 250mg QDS/ Penicillin
Up to which gestation can expectant management be considered?
37 weeks
What percentage of preterm births are associated with PPROM?
30-40%
What is the median time from diagnosis to delivery?
7 days
Which marker is most informative re infection?
CRP
GBS is a common bowel flora. What % of women are colonised?
20-40%
Why is GBS not screen for in late pregnancy?
Many women with GBS- baby unaffected
Screening does not predict affected babies
If screening done at 35-37 weeks- 17-25% will be negative at delivery
SEs of antibiotics
Many affected babies are born prematurely
If women choose to have screening, when is it reccommended?
35-37 weeks
32 weeks for twins
Risk factors for early onset GBS (within 7 days of delivery?
6
Prev GBS Known GBS PTB PROM Suspected chorio Pyrexia in labour
Risk of eogbs if gbs -ve?
1/5000
Risk if gbs in prev pregnancy?
1/800
Risk if gbs current preg?
2.3/1000
risk Intrapartum pyrexia?
5.3/1000
If GBS in preg pregnancy, what is the risk of carriage in this pregnancy?
50%
If woman have GBS bacteriuria what should you do?
Treat and off IAP
Do not treat GBS+ve vaginal/ rectal swabs
Should women have elcs have antibiotic prophylaxis?
No
Can women with GBS have water birth?
Not recommended
GBS and SROM at term?
Offer immediate IAP and IOL
If carrier status unknown- offer option of immediate IOL or IOL 24 hours
Why should all women in preterm labour be offered IAP?
Mortality rates
Risk of mortatlity preterm is 20-30% vs 2-3% at term
PPROM and known GBS?
At which gestation should baby be delivered?
From 34 weeks
<34- cont pregnancy
What should you do if mother declines IAP?
Baby should be monitored first 12 hours of life
Abx in labour for over 4 hours before delivery
Baby does not need antibiotics
What is the treatment for EOGBS?
Penicillin and gent- ideally within 1 hour
