GBS- After GBS+ with Last 2 Preg?

First, I want to say that I've only had one child. However, I can tell you this, at my 37 or 38 week appt I had my GBS test and was told that it was negative. When my daughter was late and I was induced at 41 weeks, they performed the test again. I told them that I had already tested negative but they informed me that the test was only good for 2 weeks. This time I had tested positive and had to have the antibiotics. (Which really sucked, btw!) I understood it to be like an infection, which just comes and goes as it pleases. Hope this helps you.

I was GBS+ with my first daughter, but GBS- with my second. I thought that was strange and asked the doctor, but he said it was taken pregnancy by pregnancy and it didn't matter if I was positive before. I didn't receive antibiotics and we were both fine.

Good luck with #3!

Hi J.!

I was positive with my first daughter and negative with my second who was born 14 months later. I can't explain it either, but both my girls are perfectly fine. It seemed strange to me at the time, but I guess that is one of the many things that can be different for each pregnancy. Best of luck to you!

Hi J.:
I'm a Certified Nurse-Midwife and hope to clarify this issue for you. Group B Beta Strep occurs in 10-30% of individuals and comes and goes... intermittent colonization. Just because you had it twice before doesn't necessarily mean you'll have it again. The Center for Disease Control (CDC) recommends that any women who had delivered a baby that developed group B strep sepsis automatically receive prophylaxis or antibiotics in labor. This does not apply to women with a history of testing positive. This is why your doctor does not recommend treatment. I can understand your concern but perhaps it will ease your mind to know that even of all the women who test positive in pregnancy, only 3% of their babies are at risk for developing the infection after birth. There are great educational brochures online through the CDC websites. There is a link to the consumer and the professional sites.
Hope this is helpful! L. Anderson, CNM in Reno

I'm a labor and delivery nurse and wanted to let you know how gbs relates to the birthing process. gbs is a type of bacteria that lives in the vaginal cannal of a woman. some women have it, some women don't. some women may develop it in due course of the pregnancy. that's why it is optimal to check between 36-38 weeks of pregnancy. sometimes we check in the hospital when you are admitted. i've had women whose prenatal records show positive, then check again and it's negative by the time labor starts and admitted to hospital. my suggestion is to let the nurses know when you do go into labor, so they can care for you knowing that you've had a positive gbs in the passed pregnancies. antibiotics wouldn't hurt you, but if you had any underlying illness, it would mask it from being discovered. i would suggest you have a clear understanding with your doctor so that he/she can best attend your needs. hope it was helpful, PEACE!

There are some hospitals that feel "once positive, always positive" and others who don't. At your next visit, ask your doctor to prescribe antibiotics for you in labor (they can't give them unless he says to) just to put your mind at ease. A little extra Penicillin usually doesn't hurt anyone, and it will make you feel less nervous.

Hi J.,I am an ob/gyn np and you don't need to get nervous because if you have had +GBS before with your other pregnancies it is not an indication that you will have it again....it is only coincident.the standard of care is to give IV antibiotic during labor only to the mothers who are +GBS 4 weeks prior to delivery regardless of their previous history.therefore relax and enjoy the rest of your pregnancy...good luck and congrad....your baby will be fine.
PS : afther reading all the respons..I have to say I was disappointed mostly with the knowledge of the l&d nurses!!!!!

I noticed that someone had responded to you saying that "GBS is a joke." here is the message I sent to her.

I hope you find what you are looking for and get all the information you need to make the best decision for you and your family.

It reads:

you recently responded to a question regarding GBS status during pregnancy.

I couldn't help but feel that you are doing such a disservice to mothers that read your response by stating that it is "a joke."

granted not all testing is 100% accurate. but the truth is that while it can be harmless in adults, babies can die from this bacteria.

i recommend that everyone does her own research so that she can be able to make an informed decision. medical professionals are there to give you information based on their extended education and current research practices with your best interest and safety in mind.

Hi J.,
I tested negative for my first, positive for my second, and then negative for my third, however they ran the test again once I got to the hopsital with my third and then tested positive, they were able to start me on the antibiotics. All of my labors have been so quick that on my third one I was only able to recieve one dose of antibiotics, but everything turned out just fine. I wouldn't stress too much about it. When you get to the hospital you can tell them you tested negative but have been positive in the past. Congratulations!

I was GBS+ for my first pregnancy, but negative for the 2nd pregnancy. I was a little worried, but we didn't have any problems despite the lack of antibiotics. Our 2nd little boy was very, very healthy. No problems at all.

The vaginal flora (bacteria living in the vagina) changes all the time. It is very possible to be - or + for Group B strep at different times. In fact, I was GBS- with my two sons, and with my daughter (#3) I was GBS+. My labor was so fast (3 hours and 50 minutes from the time I left my house until the time she was born) and I spend 3 hours and 30 minutes of that in triage because they didn't think I was so close (despite telling them repeatedly) that I didn't get a chance to have antibiotics, and that was with a + test. They cultured my daughter twice before I was released. I wouldn't be nervous, but if you are going to have an IV anyway (which you will if you get an epidural) than I would ask for the antibiotics just to be safe. Doctors are often reluctant to do that, because it can be dangerous to expose bacteria to antibiotics for no reason, but it is worth a shot. Good luck!

Yes you are over reacting....it's much better not to get antibiotics if you don't have too. GBS comes and goes...if you tested neg then thank your lucky stars and move on. It's really a rare thing for the baby to get infected anyway. Don't worry and enjoy the rest of your pregnancy....

GBS testing is a joke. GBS normally resides in the colon, so since the vagina is so closely located, it can easily get transferred to the vaginia from the colon with a few bad wipes, etc. I read somewhere that there is a 40% false positive testing rate for GBS.

In fact, a retrospective study done in Kaiser Permanente hosptials over 8 years and looking at 278,000 moms/babies. Of course, it showed that 100% of babies (not 98%) who got the antibiotics (ABX) were sick within 24 hours of the administration of ABX.
CONCLUSIONS: Exposure to antibiotics during labor did not change the clinical spectrum of disease or the onset of clinical signs of infection within 24 hours of birth for term infants with EOGBS infection. A 48-hour stay is not required to monitor asymptomatic term infants exposed to intrapartum antibiotics for onset of GBS infection.
Pediatrics. 2000 Aug;106(2 Pt 1):244-50.

Don't stress. Even taking something like PB8 from www.nutritionnow.com will keep your vaginal flora healthy and the baby is usually healthier, as well. I've known GBS+ moms who did not do ABX and they were fine, not that I'm advocating that, but since you are negative - enjoy the freedom and the fact that your baby won't end up with intestinal/digestive issues from the ABX.

Good luck with your birth!
S.

I think you should explain your concern to your Doctor and request that he give you the antibiotics anyway. Or maybe you should get a second opinion just to ease your mind.

Try not to be nervous. Stress is an immune depressant. Instead cultivate a feeling of deep trust. Stay positive and don't believe the "once positive always positive" perspective. The beautiful source of life that is growing a child inside of you is also capable of many miracles.

Shiitake mushrooms are proven to be antiviral & anti-strep. Start fixings them in a stir fry. Eat garlic and other antiviral & antibacterial foods. There are also homeopathics available over the counter at your local health food store.

Don't put your health and your child's health at risk by using antibiotics. They are excessive and damaging to a sensitive newborn. Not the best thing to have in your breast milk either.

Trust that your are taken care of and protected.

Hi J.!
I think it would be important to be rechecked. Your GBS status can change. If you know you are a carrier, you should be treated with antibiotics. It could make all the difference.
There is a wonderful group called group b strep international and they have a website with a ton of info. Also, I belong to a Yahoo group for families who have been effected by GBS. They also have a lot to offer.
Hope this helped a little. Good Luck!
-K.

I was + with the first and - with the second. My doc said it is completely normal to be + for one and not with the other

Hi J. -

I tested - with my 1st and to my surprise I was + with my second. This sent me into a huge whirlwind of research b/c I was really freaked out. What I did learn was that if you test positive at any time then this means that you do carry the bacteria and it is possible for it to show up in your body/vaginal tract at any time. So even if you are - at 37 weeks, you could be + at 39 weeks and vice versa. Why they do not have a rapid strep culture test for this at the hospital is beyond me, it would make much more sense. For this reason I will be requesting antibiotics w/my next labor (pregnant now) even if I am -, and if I were you I would too. I am sure your doc won't have a problem w/it. Good luck w/your labor and new little one!!

J.,

Congratulations on your pregnancy!
I think you will find this information helpful...the website I obtained it from was www.midwiferytoday.com

Group B Streptococcus

About 40% of adults are carriers of Group B Streptococcum (GBS) in their genital or intestinal tracts. Usually, GBS doesn't cause problems. In fact, in most healthy adults it is considered a "normal" organism, and treatment with antibiotics is not given. It does have significance for the pregnant woman, however. GBS, which can be passed from mother to baby during childbirth, is the leading cause of newborn sepsis--serious infection throughout the baby's body soon after birth.

A specific combination of factors seems to be at work in babies who develop GBS disease. It is most likely to develop in babies whose mothers are carriers of GBS and who have one or more clinical risk factors. In these babies, who are at the highest possible risk for GBS disease, about five out of 100 will develop it. Babies whose mothers are GBS carriers but have no clinical risk factors are less likely to develop GBS disease: about one in 200 babies will get GBS disease. Those whose mothers have clinical risk factors but test negative for GBS are even less likely to develop GBS disease--about 1 in 1000--and those whose mothers have neither risk factors nor a positive GBS culture have a very small chance of getting GBS disease--about 1 in 3000.

Clinical Risk Factors for Developing GBS Disease:
Prenatal risk factors: Previous baby with GBS disease; urinary tract infection with GBS at any time during this pregnancy
Labor-related risk factors: Onset of labor before 37 weeks, rupture of membranes before 37 weeks; rupture of membranes more than 18 hours before birth; fever over 100.4 degrees during labor.
- "Group B Screening," Midwifery Today Issue 52
====

Researchers conducted a review of infants who had early-onset group B streptococcal (EOGBS) infections and were born in Southern California Kaiser Permanente Hospitals from 1988 through 1996. To summarize:

*319 infants with EOGBS sepsis, bacteremia, or clinically suspected infection were identified from a population of 277,912 live births (approximately 1 in every 870 births).
*Of the 172 term infants with culture-positive infection who had clinical signs of infection, 95% exhibited them in the first 24 hours of life.
*All of the infants exposed to antibiotics during birth became ill within the first 24 hours of life.

Researchers concluded that "exposure to antibiotics during labor did not change the clinical spectrum of disease or the onset of clinical signs of infection within 24 hours of birth for term infants with EOGBS infection."
- Pediatrics August 2000; 106: 244-250
from Dr. Joseph Mercola, www.mercola.com/2000/aug/13/group_b_strep.htm
====

At least nine types of GBS exist, but five of them cause 95 percent of the disease.
====

Incidence: Approximately 17,000 cases occur annually in the United States; approximately 7,500 occurred in newborns before recent prevention. The rate of neonatal infection has decreased from 1.7 cases per 1,000 live births (1993) to 0.4 cases per 1,000 live births (1999).
Sequelae: Neurologic sequelae include sight or hearing loss and mental retardation. Death occurs in 5% of infants and 16% of adults.
- www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_t.htm
====

Can GBS disease among newborns be prevented?

Most GBS disease in newborns can be prevented by giving certain pregnant women antibiotics through the vein during labor. Any pregnant woman who previously had a baby with GBS disease or who has a urinary tract infection caused by GBS should receive antibiotics during labor.
Pregnant women who carry GBS should be offered antibiotics at the time of labor or membrane rupture. GBS carriers at highest risk are those with any of the following conditions:
* fever during labor
* rupture of membranes (water breaking) 18 hours or more before delivery
* labor or rupture of membranes before 37 weeks
Because women who carry GBS but do not develop any of these three complications have a relatively low risk of delivering an infant with GBS disease, the decision to take antibiotics during labor should balance risks and benefits. Penicillin is very effective at preventing GBS disease in the newborn and is generally safe. A GBS carrier with none of the conditions above has the following risks:
* 1 in 200 chance of delivering a baby with GBS disease if antibiotics are not given
* 1 in 4000 chance of delivering a baby with GBS disease if antibiotics are given
* 1 in 10 chance, or lower, of experiencing a mild allergic reaction to penicillin (such as rash)
* 1 in 10, 000 chance of developing a severe allergic reaction--anaphylaxis--to penicillin. Anaphylaxis requires emergency treatment and can be life-threatening.
If a prenatal culture for GBS was not done or the results are not available, physicians may give antibiotics to women with one or more of the risk conditions listed above.
- Centers for Disease Control

Look at the CDC Web site for GBS assessment and management. In the 10-30% of pregnant women who have the bacteria in their intestine, the bacteria is usually transient, meaning if one cultured for it every week throughout a pregnancy, at times it would be + and sometimes -. The CDC recommends treating according the results of the culture done between 35 & 37 weeks (as it is most closely associated with GBS sepsis in the baby), if there is a history of a previous baby with GBS disease, or a positive urine culture for GBS at any time in the present pregnancy. There is a point at which the risk of severe life threatening reaction to the antibiotics (if given routinely) is greater than the risk of the baby getting GBS disease.
I., CNM California

PS...as I now look at the responses I also am disapointed in the lack of evidence basis for the advise. The data tells us that only about 65% of what we do is Evidence Based. Doing things based on "that is how we have always done it", or "we do it this way and we have never had a problem" is not the standard of care.

If you are nervous about it you can ask your doctor to treat you with antibiotics anyway. Many physicians regularly treat women with antibiotics just because they had a history of being positive with previous pregnancies, regardless of what their result is with the current pregnancy. It is not rare to see that, so you wouldn't be asking anything out of the norm. I know this because I am a labor and delivery nurse so I routinely get orders from the doctors. They all have their own opinions but it wouldn't hurt to ask your doctor to treat you, even if it's just for your own peace of mind!

I am a Labor and delivery nurse, and if you have been GBS + before you will always be GBS +. You definetely need anitbiotics, you do not want to deliver your baby without them. Whomever did your GBS culture probably did not do it right. I hope this helps.

I just went through the same thing. I was positive with my first only 16 months AGO! and now, come to find out, when I had my second a month ago, I was negative. The doctor originally said they were still going to give me the antibiotics but then after speaking with the OB Doctors( my DOC is a family doctor, he said it wasn't necessary. So I didn't get any in January when I had my second. She is fine. never had any problems feeding or anything. So I can't explain why it changed, but I hope this helps get rid of your worries a little bit.

I tested positive the first two times and negative the third. My doctor said that every pregnancy is different and that having a negative test is a good thing. You just have to trust your doctor and the test and know that everything is going to be fine. They'll watch the baby and give him/her medicine if needed. Have a happy and healthy delivery. :)

Yes! This happenned to me also with my third pregnany. With my first child I was positive, they told me that since I was positive with him that with any future children I would also be positive. A year later I had my second child, and was given the medicine because I was positive with my first child. When I was due with my third child I was tested and it was negative. I was also very questioning about this, and nervous (especially since it was a military facility, and well, our medical sucks), but we had our third child and she came out perfect. They monitored everything very closely.

Okay, first of all you need to see your chart asuming you don't have Kaiser. You also need to be cultured for strep. I think your doctor maybe confusing you with another patient. If you are positve you should get Antibiotic. This is your pregnancy not your ob's. Take control of this and don't be nervous! Learn if you truly were positive in your other pregnancies. This can be serious.

I am a Registered Nurse and have worked high risk at County General. W.

my ob told me that no matter what- positive or negative from now on- I would have antibiotics for any future deliveries. You can be proactive and insist on it if you are really concerned.

Hi J., I had a strange experience with this as well. I was GBS- for my first pregnancy then GBS+ for the second. I was like, how do you get this anyway? My doctor told me that over time, whatever causes it (he used some big medical term) kind of fades in and out of your system. So if you are negative this time and have been positive, it's a timing thing. I was really surprised too! So anyway if your doctor doesn't think you need antibiotics then you most likely don't. Strange as it all seems! Good luck with your delivery.

I don't know what GBS- or GBS+ is, but never the less just ask the doctor about the treatment and tell him that you are very anxious. The more information you can get, the less anxious you will be. Go on the internet and just tyupe in GBS and see what turns up. Remember there are two little boys that love you and depend upon you to be close to them . Children are very sensitive to their parents moods, so keep that in mind.

C. N.

Can you ask for a "retest"? Just to put your mind at ease? I think you're fine and it's great that you don't have to go on antibiotics, but if it's stressing you out...