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Strep B test/treatment


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#1 3inthebed

Posted 07 January 2013 - 01:36 PM

In between having my last baby and this one (due in 8 weeks) the GBS test has become optional rater than compulsory at my hospital. I am not opposed to the test or the treatment (was positive last time) but now since it is not compulsory to test I am considering skipping the test.

If you are "unknown GBS status" when delivering at my hospital, they just take extra temperature readings of baby once born and suggest a 48 hour stay to monitor baby just in case.

I wil certainly allow treatment of baby in the event of any worrying signs post birth.

My reasons for thinking this way are mainly due to the fact that my labours seem to be too quick to deliver the required amount of antibiotic anyway, there was a bit of stress having my newborn with canula in arm all bandaged and splinted up  making feeding difficult and ending up being unnecessary anyway, plus the risk of thrush with antibiotics (which has plagued me this pregnancy).

I want to be informed as possible, so can anyone see any potential issues with this strategy I am contemplating? I have a few weeks to make up my mind.

#2 Soontobegran

Posted 07 January 2013 - 02:04 PM

QUOTE (silvek1978 @ 07/01/2013, 02:36 PM) <{POST_SNAPBACK}>
My reasons for thinking this way are mainly due to the fact that my labours seem to be too quick to deliver the required amount of antibiotic anyway, there was a bit of stress having my newborn with canula in arm all bandaged and splinted up  making feeding difficult and ending up being unnecessary anyway, plus the risk of thrush with antibiotics (which has plagued me this pregnancy).


Won't comment about having the test or not because everyone needs to make an informed and educated decision that is right for them but I just wanted to say that having a cannula in your arm for a couple of doses of antibiotics should not get in the way or need to be splinted. It should be able to be removed after the delivery meaning it won't get in the way of feeding either.

If you need one then ensure they insert it onto the top of your forearm, it will not need splinting or bandaging and does not restrict movement in labour.
Good luck.

#3 scarfie

Posted 07 January 2013 - 03:16 PM

STBG, I think the OP was referring to a cannula in her newborns arm, which may have been deemed necessary if she did not receive adequate cover of IVAB's during her quick labour.  I might be wrong though, that is just how I read it.

At the hospital I work at, if you do not test you are deemed negative, just make sure that is not the case at your hospital.  Ask to see the policy regarding this.  But, of course, if you don't mind having a 48 hour postnatal stay, then it could be a good reason not to do it!

As STBG says, it is important that you make an informed consent, you need to decide what risk your newborn has of contracting GBS and make your decision based on that.



#4 Soontobegran

Posted 07 January 2013 - 03:20 PM

Ahh, you could be right there scarfie now that I have re read it original.gif



#5 crackles

Posted 07 January 2013 - 03:23 PM

Op was referring to the baby having the cannula and arm splint. My ds had it done as he had a slight temp after he was born (turned out it was totally unnecessary) and is annoying when trying to feed and dress Bub.
Op I want an answer to this too as my labours are generally too quick for me to have the antibiotics myself (assuming I test +)
I guess I'll just have to stay the 48hrs they recommend while they wake the Bub every hr and don't bother resettling it (as they did with ds - very annoying!)

#6 Soontobegran

Posted 07 January 2013 - 07:36 PM

QUOTE (crackles @ 07/01/2013, 04:23 PM) <{POST_SNAPBACK}>
Op was referring to the baby having the cannula and arm splint. My ds had it done as he had a slight temp after he was born (turned out it was totally unnecessary) and is annoying when trying to feed and dress Bub.
Op I want an answer to this too as my labours are generally too quick for me to have the antibiotics myself (assuming I test +)
I guess I'll just have to stay the 48hrs they recommend while they wake the Bub every hr and don't bother resettling it (as they did with ds - very annoying!)


I really do understand the annoyances but I think it pays to remember the devastation that can occur if your newborn contracts Strep B. I think I'd rather be over vigilant than slack.


#7 imamumto3

Posted 07 January 2013 - 07:48 PM

I was gbs positive for my third pregnancy.  I had a fast delivery for my second (vbac), so being positive was one of the reasons I was induced for #3, to be able to get at least 1 dose of abs in.  I'm glad that I did it that way, a bit less stress after delivery

#8 ~sydblue~

Posted 07 January 2013 - 07:57 PM

QUOTE (soontobegran @ 07/01/2013, 08:36 PM) <{POST_SNAPBACK}>
I really do understand the annoyances but I think it pays to remember the devastation that can occur if your newborn contracts Strep B. I think I'd rather be over vigilant than slack.

I agree. Better to be on the safe side.

#9 monkeys mum

Posted 08 January 2013 - 01:55 AM

I was positive in my last pregnancy and it is my understanding that i will be treated as positive this pregnancy, though its on my list of q's to ask next appt.

My last labour was quick, but i also had to have ivabs due to allergic reactions to an ab. They pushed this through in about 40minutes as the midwife was getting concerned as delivery seemed to be very close. I am happy i had it even though i hate canullas, i figure a pain in the behind drip is a lot better then a sick newborn, also my thinking was even if it didnt all finish at least some was better then none.

I guess what you need to find out is if being positive in the past if you will be treated as positive no matter what, if you dont get the full amount of abs on board can a wait and see approach be done instead of straight to a drip in bub. Can you call ahead so there is no delay in waiting for the abs to arrive. Do you need iv abs or can you get them via injection?

I guess the other thing to think about is even though you have had a quick delivery doesnt mean this one will be quick. I also didnt have my waters break naturally and they werent broken till after the drip had finished, so in your labour is there something that could be done to help the abs get through. Even if its heading to the delivery ward as soon as you think its all starting.

Research both by yourself and from talking with your ob, midwife etc should all be taken into account when making your decision.

#10 Natttmumm

Posted 08 January 2013 - 07:12 AM

I would get the test so you know what's required. If you don't have it then no dramas

#11 Koobie83

Posted 08 January 2013 - 09:02 AM

I would too - there's no harm in testing right?
I have been told I will need to be tested because I've had it before, but when I was tested a few weeks ago or so it was negative. So hopefully it stays this way.

#12 Leee

Posted 08 January 2013 - 09:08 AM

I don't like how some hospitals now assume you are positive if you were a previous time, this was not the case for me.

I was positive the first two times, with the second birth I did not have time for antibiotics. For my third I refused the test as it was not going to make me go to the hospital earlier just to have antibiotics. I then got to 40 weeks and was looking at being induced so had it done. I then went into labour three days later. When I arrived they checked the results and they were negative, so all my worry about whether or not to test was for nothing.

I know GBS infections are very serious. I do though have some concerns about being labelled positive when at delivery you could be negative and vice versa. I also think you you have to consider the risks - prolonged second stage and prolonged rupture of membranes would put you at greater risk and this was not the case in any of my labours.

#13 3inthebed

Posted 08 January 2013 - 11:20 AM

Sorry I did mean the canula in baby not me. ALthough the canula in my arm did take 1 hour to put in, caused a massive bruise and meant I couldn't lean on my wrists in labour, so it did greatly restrict me. This is not a deal breaker though. I am happy to put up with a bit of discomfort. The canula in babys arm did make an already painful feeding process even more awkward. Again, not a deal breaker.


QUOTE (soontobegran @ 07/01/2013, 08:36 PM) <{POST_SNAPBACK}>
I really do understand the annoyances but I think it pays to remember the devastation that can occur if your newborn contracts Strep B. I think I'd rather be over vigilant than slack.


STBG I really do appreciate your advice (since I believe you are in the field of midwifery - i think???). I would in no way want to take risks (i am not a risk taker at all) but I was hoping my strategy will negate most risk. Would I still be vigilant if my hospital policy is that they assume I am positive and hence monitor baby for 48 hours? Then administer what is needed WHEN it is needed, as opposed to administering potentially unnecessarily. I fully understand the devastation that can occur if baby contracts Strep B but if they are monitoring temps for 48 hours shouldn't it be picked up then dealt with? I am thinking it would be no different to my last birth where there was not enough time for ABs in labour so baby was monitored for 48 hours. Or is there a factor I haven't thought of?




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