PPRom and GBS

Question 1

Which antibiotics for pprom?

Answer 1

Erythromycin 250mg QDS/ Penicillin

Question 2

Up to which gestation can expectant management be considered?

Answer 2

37 weeks

Question 3

What percentage of preterm births are associated with PPROM?

Answer 3

30-40%

Question 4

What is the median time from diagnosis to delivery?

Answer 4

7 days

Question 5

Which marker is most informative re infection?

Answer 5

CRP

Question 6

GBS is a common bowel flora. What % of women are colonised?

Answer 6

20-40%

Question 7

Why is GBS not screen for in late pregnancy?

Answer 7

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

Question 8

If women choose to have screening, when is it reccommended?

Answer 8

35-37 weeks

32 weeks for twins

Question 9

Risk factors for early onset GBS (within 7 days of delivery?

6

Answer 9

Prev GBS
Known GBS
PTB
PROM
Suspected chorio
Pyrexia in labour

Question 10

Risk of eogbs if gbs -ve?

Answer 10

1/5000

Question 11

Risk if gbs in prev pregnancy?

Answer 11

1/800

Question 12

Risk if gbs current preg?

Answer 12

2.3/1000

Question 13

risk Intrapartum pyrexia?

Answer 13

5.3/1000

Question 14

If GBS in preg pregnancy, what is the risk of carriage in this pregnancy?

Answer 14

50%

Question 15

If woman have GBS bacteriuria what should you do?

Answer 15

Treat and off IAP

Do not treat GBS+ve vaginal/ rectal swabs

Question 16

Should women have elcs have antibiotic prophylaxis?

Answer 16

No

Question 17

Can women with GBS have water birth?

Answer 17

Not recommended

Question 18

GBS and SROM at term?

Answer 18

Offer immediate IAP and IOL

If carrier status unknown- offer option of immediate IOL or IOL 24 hours

Question 19

Why should all women in preterm labour be offered IAP?

Mortality rates

Answer 19

Risk of mortatlity preterm is 20-30% vs 2-3% at term

Question 20

PPROM and known GBS?

At which gestation should baby be delivered?

Answer 20

From 34 weeks

<34- cont pregnancy

Question 21

What should you do if mother declines IAP?

Answer 21

Baby should be monitored first 12 hours of life

Question 22

Abx in labour for over 4 hours before delivery

Answer 22

Baby does not need antibiotics

Question 23

What is the treatment for EOGBS?

Answer 23

Penicillin and gent- ideally within 1 hour